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Molecular Testing

KRAS, BRAF and Other — Common Mutations Explained

Finding a mutation name on your biopsy report can be alarming. It is not a prognosis. It is a description of your cancer's biology — and it is how your oncologist decides which treatments are worth trying.

Medically reviewed by Dr. T. Raghavender Reddy, Medical Oncologist, MBBS · DM (Medical Oncology) · MD (Radiation Oncology) · Last reviewed September 2026

  • A mutation is not a verdict — It describes the cancer's biology, not how advanced it is or how it will behave.
  • Different mutations matter differently — Some have targeted treatment options in certain cancers; others guide decisions without a direct targeted approach.
  • The cancer type still matters — The same mutation can mean very different things depending on where the cancer started.
  • Your oncologist interprets the result — The report names the mutation. Your treating team decides what it means for your plan.
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KRAS and BRAF are genes that control cell growth. A mutation means a change was found in that gene in your cancer cells. These changes are identified from biopsy tissue and influence which treatments may suit you. Some mutations are targetable in certain cancers; others guide treatment without a direct targeted option.

What does a gene mutation on a biopsy report actually mean?

A mutation found on your biopsy report means the DNA of a particular gene has changed from its normal sequence in your cancer cells. Genes like KRAS and BRAF normally control how cells grow and divide. When they carry a mutation, that control is disrupted.

Finding a mutation is not the same as saying your cancer is more aggressive or more advanced. It is a biological description. Your oncologist uses it to identify which treatments are most likely to help — and which are not.

These results come from molecular or genomic testing done on biopsy tissue. The test looks for changes relevant to treatment decisions now or in the future.

What do KRAS, BRAF and other mutation names on your report mean?

KRAS mutation
KRAS is one of the most commonly mutated genes across cancer types. It appears frequently in colorectal, lung and pancreatic cancers. Different variants of KRAS carry different implications, and whether a targeted option exists depends on the specific change and your cancer type.
BRAF mutation
BRAF mutations appear in melanoma, colorectal cancer, thyroid cancer and some lung cancers, among others. The specific variant matters: some BRAF changes have targeted options available in certain cancers; others do not. Your oncologist will explain what yours means.
NRAS mutation
NRAS is in the same signalling pathway as KRAS. It is found in melanoma and some colorectal cancers. Its presence can indicate that certain treatment combinations are unlikely to help, which is itself an important piece of information for your plan.
PIK3CA mutation
PIK3CA is commonly found in breast, colorectal and cervical cancers. Targeted options exist for some PIK3CA mutations in certain cancer types, and the finding is increasingly relevant to treatment planning.
TP53 mutation
TP53 is one of the most commonly mutated genes across all cancers. Most TP53 mutations do not currently have a direct targeted treatment, but the finding remains relevant to understanding the cancer's biology and behaviour.
Wild-type
Wild-type means no mutation was detected in that gene by the test used. It is not a simple all-clear — it means the specific variants the test was designed to find were not present in your sample.
Variant of uncertain significance (VUS)
A VUS is a DNA change whose clinical meaning is not yet established. It is not a confirmed cancer-driving mutation. Classification can change as evidence grows. In most cases, a VUS does not directly affect your immediate treatment plan.

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Are KRAS and BRAF mutations targetable?

The answer depends on which specific variant was found and which cancer type you have. Not every change within a gene carries the same implications. ASCO and ESMO guidance identifies specific combinations of cancer type and mutation variant that have a recognised targeted pathway.

Some mutations that were considered untreatable a few years ago now have options in certain cancers. Your oncologist's recommendation reflects current evidence, not a fixed historical rule.

If your mutation does not currently have a targeted option in your cancer type, that does not mean you have no treatment options. It means those options look different — and your team can explain what they are.

Which mutation details actually change your treatment options?

Why does the subtype of a KRAS mutation matter — for example G12C versus G12D?

Different changes within the same gene affect the protein it produces in different ways, and may respond differently to treatment approaches. Two people both described as having a KRAS mutation may have very different treatment pathways depending on exactly which variant is present. This is why the full report — not just the gene name — is what your oncologist reads carefully. Ask your team to explain your specific variant, not just the gene it sits in.

BRAF was found on my report — does that tell me anything about which cancer I have?

No. Finding a BRAF mutation does not change your diagnosis or the type of cancer you have. It describes the biology of the cancer you already have a diagnosis for. BRAF mutations appear across a range of cancer types, and your oncologist explains what the finding means within the context of your specific cancer. The mutation name and the cancer type are two separate pieces of information that are read together.

The report includes a 'variant of uncertain significance' — is that bad news?

A variant of uncertain significance, or VUS, is a DNA change whose meaning is not yet clearly established in the scientific literature. It is not a confirmed cancer-causing mutation, and it is not the same as a normal result. It means we do not yet know what role, if any, this change plays. Classification can change over time as evidence accumulates. In most cases a VUS does not affect your immediate treatment plan, and your oncologist will tell you whether this one is relevant to your situation.

A mutation was found but my oncologist says targeted therapy is not an option — why?

Whether a mutation leads to a targeted treatment depends on both the specific variant and your cancer type. A mutation that opens a targeted pathway in one cancer type may have no equivalent option in another. Your oncologist's answer reflects current ASCO and NCCN guidance on which specific combinations of mutation and cancer type have an established targeted approach. If the reasoning is unclear, ask them to explain which criteria your result did or did not meet.

Can the mutation found on biopsy change if the cancer comes back or spreads?

Yes. Tumours can evolve over time, and testing done at a recurrence or a new site may show different results from the original biopsy. This is one reason oncologists sometimes recommend repeat molecular testing at key decision points, rather than relying solely on earlier results. If your cancer has progressed or spread, it is reasonable to ask whether updated testing would change what treatment options are available.

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Common questions

Frequently asked questions

What is the difference between a mutation and a variant?

Both words describe the same thing: a change in a gene's DNA sequence from the normal reference. The word 'variant' is increasingly preferred in medical reports because it is more precise. Your report may use either term. The important details are the name of the gene, the specific change identified, and what your oncologist says it means for your treatment — not which word was used to describe it.

Does a KRAS or BRAF mutation mean my children could inherit it?

No. Mutations found on cancer biopsy testing are somatic — they arose in the cancer cells during your lifetime and are not inherited. They cannot be passed on. Separate germline or hereditary testing, which is a different test entirely, examines whether a cancer-predisposing mutation runs in the family. If your oncologist thinks that kind of testing is relevant for your family, they will refer you for it. Your biopsy molecular report does not answer that question.

How long does it take to get molecular test results from a biopsy?

Standard targeted biomarker panels typically take one to two weeks from when the sample reaches the laboratory. More comprehensive genomic panels, or samples sent to specialist laboratories, can take longer. Ask your team when the sample was dispatched and what timeline to expect. Having a date means you know when to follow up rather than waiting without a reference point.

My report shows more than one mutation — does that mean the cancer is worse?

Not necessarily. It is common for a cancer to carry more than one mutation, and the number found is not a direct indicator of severity. Some cancers with a high number of mutations actually respond better to certain treatment approaches. Your oncologist reads the full picture — the combination of mutations, the cancer type and stage, and current evidence — rather than treating each mutation in isolation.

Should we seek a second opinion on the molecular results?

A second opinion on the laboratory result itself is rarely necessary — accredited laboratories use validated assays and results are generally reliable. What can be valuable is a second opinion on how those results are being applied to your treatment plan, particularly if a rare mutation was found or the recommendation is unexpected. A tumour board review achieves something similar: your case is assessed by multiple specialists together, which many centres do routinely for complex results.

We cannot afford comprehensive genomic testing — are simpler tests still useful?

Yes. Targeted panels that test for specific mutations relevant to your cancer type are often sufficient for treatment decisions and cost considerably less than a full genomic profile. Your oncologist selects the level of testing based on what information is actually needed for your case. Costs vary by panel, laboratory and location and are indicative; ask your team what is being recommended and what it is expected to cost before the sample is sent.

Full index

Browse all 701 biopsy topics

Every page in this section, grouped by the part of the journey it belongs to. Pick a group to see what is in it.

What Is a Biopsy?

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Types of Biopsy Compared

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Preparing for a Biopsy

What to Expect on the Day of Your Biopsy →

Recovery and Aftercare

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Biopsy by Body Part

Biopsy by Body Part: What to Expect at Each Site →

Understanding Your Report

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IHC and Molecular Markers

IHC and Molecular Markers on a Biopsy: What They Mean →

Grading and Scoring Systems

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If Your Result Is Benign

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