Lots has changed in melanoma over the past five years and certainly in the past 10. BRAF testing is now standard of care for lesions of any consequential size. Additionally, many "tests" are currently being studied in melanoma patients and each day brings them closer to being validated and available, thanks to a whole lot of ratties. These may prove to be valuable in determining not only things like BRAF status and tumor burden via assay of the blood for bits of DNA..but for indicating more effective treatment options and presence of disease or progression. Here is a report on just a few if you are interested:
http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2018/04/simple-blood-tests-that-tells-us-where.html
Genetic testing of tumor itself, beyond BRAF is often done in a couple of circumstances: When a patient has failed usually effective melanoma treatment options or when presentation is more in line with a known genetic mutation (multiple family members with melanoma, repeated primary lesions, the presence of additional cancers, etc). We have several on this forum, who progressed on melanoma drugs…but then with genetic testing was able to find effective therapy. For instance, on poster's husband turned out to have the HER-2 mutation, more common in breast cancer, but once treated with drugs effective for that, has done very well.
Additionally, NRAS, CKIT, and many other mutations are frequently checked in melanoma. Again, what is done is usually determined by patient's request, whether or not the MD is at the top of his/her game (another reason it is important to see a melanoma specialist), how state-of-the-art the pathologist and lab used are, and patient's presentation.
This chart demonstrates the many molecular presentations of melanoma (and we are still learning!):
http://chaoticallypreciselifeloveandmelanoma.blogspot.com/2015/04/melanoma-pathwaysa-melanoma-molecular.html
Not sure if all this really answers your question, but hope it helps and I wish you well. Celeste
.
