Ron Balassanian, MD

Professor
Pathology
+1 415 514-6642

Dr. Ronald Balassanian is a pathologist (a specialist in examining tissue samples for signs of disease) in the UCSF Fine Needle Aspiration (FNA) Biopsy Clinic at Mission Bay. He performs fine needle aspiration biopsies – removing sample cells with a needle and syringe – primarily on lumps in areas such as the breasts, thyroid or lymph nodes. This procedure can yield a quick assessment of whether a lump is benign or malignant, usually in a day or two. In some cases, ultrasound is used to guide the needle when obtaining a biopsy.

In his research, Balassanian studies minimally invasive diagnosis through FNA biopsy and investigates the use of molecular diagnostics to increase the value of FNA biopsy. He also studies breast cancer diagnosis through FNA biopsy and surgical pathology (analyzing samples removed during surgery). He is involved in the I-SPY research trials, which aim to hasten the availability of better, more personalized treatments. He also participates in the Athena Breast Health Network, a framework to allow doctors to learn from all 150,000 patients at UC medical centers and their affiliates rather than from only the patients they treat or those in clinical trials. In addition, he leads a research project called "Ask Your Pathologist," which has the goal of improving communication between pathologists and breast cancer patients.

Balassanian earned his medical degree at the University of Vermont Larner College of Medicine. At UCSF, he completed residency training in pathology and laboratory medicine, as well as fellowship training in surgical pathology and cytopathology.

Balassanian is a fellow of the College of American Pathologists. He is a member of the United States and Canadian Academy of Pathology, American Society for Clinical Pathology, American Society of Cytopathology and Papanicolaou Society of Cytopathology. He participates in the UCSF Global Cancer Program, contributing to teaching, implementation and research projects on breast FNA biopsy in Peru and Tanzania.

Publications: 

Datopotamab-deruxtecan in early-stage breast cancer: the sequential multiple assignment randomized I-SPY2.2 phase 2 trial.

Nature medicine

Khoury K, Meisel JL, Yau C, Rugo HS, Nanda R, Davidian M, Tsiatis B, Chien AJ, Wallace AM, Arora M, Rozenblit M, Hershman DL, Zimmer A, Clark AS, Beckwith H, Elias AD, Stringer-Reasor E, Boughey JC, Nangia C, Vaklavas C, Omene C, Albain KS, Kalinsky KM, Isaacs C, Tseng J, Roussos Torres ET, Thomas B, Thomas A, Sanford A, Balassanian R, Ewing C, Yeung K, Sauder C, Sanft T, Pusztai L, Trivedi MS, Outhaythip A, Li W, Onishi N, Asare AL, Beineke P, Norwood P, Brown-Swigart L, Hirst GL, Matthews JB, Moore B, Fraser Symmans W, Price E, Beedle C, Perlmutter J, Pohlmann P, Shatsky RA, DeMichele A, Yee D, van 't Veer LJ, Hylton NM, Esserman LJ

Change in Biomarker Profile After Neoadjuvant Chemotherapy is Prognostic and Common Among Patients with HER2+ Breast Cancer.

Annals of surgical oncology

Tchou J, Gottipati S, Goldbach M, Baxter M, Venters S, Balassanian R, Vohra P, Gonzalves D, Ahmad Z, Nayak A, Boughey JC, Mukhtar RA, Chen YY

Unleash your potential: Inside interventional pathology.

Cytopathology : official journal of the British Society for Clinical Cytology

Villar-Zarra K, Balassanian R, Vielh P

Demographic and clinical characteristics of patients with metastatic breast cancer and leptomeningeal disease: a single center retrospective cohort study.

Breast cancer research and treatment

Huppert LA, Fisch S, Tsopurashvili E, Somepalle SS, Salans M, Vasudevan HN, Jo Chien A, Majure M, Rugo HS, Balassanian R, Boreta L, Melisko ME

Wilms Tumor: An Unexpected Diagnosis in Adult Patients.

Archives of pathology & laboratory medicine

Chan GJ, Stohr BA, Osunkoya AO, Croom NA, Cho SJ, Balassanian R, Charu V, Bean GR, Chan E

Utility and performance of cell blocks in cerebrospinal fluid cytology: Experience at two teaching hospitals.

Cancer cytopathology

Yoon H, Chen CV, Krishnan V, Grochowski J, Iezza G, Vohra P, Balassanian R, Greenland NY

Education and diversity in cytopathology: Past, present, and future.

Diagnostic cytopathology

Fitzhugh VA, Reynolds JP, Flanagan M, Balassanian R

Cytopathology in the era of social media.

Diagnostic cytopathology

Baskota S, Shaker N, Balassanian R, Vohra P

Science, Medicine, and Cytology: an educational program of the Diversity, Equity, and Inclusion Committee of the American Society of Cytopathology.

Journal of the American Society of Cytopathology

Gimenez C, Balassanian R, Banet N, Barkan G, DeRobbio K, Henderson-Jackson E, Jenkins E, Kilic A, Lai L, Lura T, Morgenstern N, Mito J, Reid MD, Rivera-Colon G, Stewart J, Lowe AC

Fine needle aspiration biopsy in low- and middle-income countries.

Diagnostic cytopathology

Khorsandi N, Balassanian R, Vohra P

Utility and performance of cell blocks in urine cytology: Experience at three teaching hospitals.

Cancer cytopathology

Greenland NY, Khorsandi N, Peng Y, Balassanian R, Tabatabai ZL, Tiffany Shing TW, Vohra P

One procedure-one report: the Re-Imagine Cytopathology Task Force position paper on small tissue biopsy triage in anatomic pathology.

Journal of the American Society of Cytopathology

Ly A, Balassanian R, Alperstein S, Donnelly A, McGrath C, Sohani AR, Stelow EB, Thrall MJ, Zhang ML, Pitman MB

Small volume biopsy diagnostic yield at initial diagnosis versus recurrence/transformation of follicular lymphoma: A retrospective Cyto-Heme Interinstitutional Collaborative study.

Cancer cytopathology

Fitzpatrick MJ, Sundaram V, Ly A, Abramson JS, Balassanian R, Cheung MC, Cook SL, Falchi L, Frank AK, Gupta S, Hasserjian RP, Lin O, Long SR, Menke JR, Mou E, Reed DR, Ruiz-Cordero R, Volaric AK, Wang L, Wen KW, Xie Y, Zadeh SL, Gratzinger D

Diagnostic Discrepancies in Small-volume Biopsy for the Initial Diagnosis, Recurrence, and Transformation of Follicular Lymphoma: A Multi-Institutional Collaborative Study.

The American journal of surgical pathology

Volaric AK, Lin O, Balassanian R, Cook S, Falchi L, Fitzpatrick MJ, Frank AK, Gupta S, Hasserjian RP, Long S, Ly A, Menke JR, Mou E, Natkunam Y, Reed DR, Ruiz-Cordero R, Wang L, Wen KW, Xie Y, Zadeh SL, Gratzinger D, and the Cyto-Heme Institutional Collaborative (CHIC) Consortium

Association of Residual Ductal Carcinoma In Situ With Breast Cancer Recurrence in the Neoadjuvant I-SPY2 Trial.

JAMA surgery

Osdoit M, Yau C, Symmans WF, Boughey JC, Ewing CA, Balassanian R, Chen YY, Krings G, Wallace AM, Zare S, Fadare O, Lancaster R, Wei S, Godellas CV, Tang P, Tuttle TM, Klein M, Sahoo S, Hieken TJ, Carter JM, Chen B, Ahrendt G, Tchou J, Feldman M, Tousimis E, Zeck J, Jaskowiak N, Sattar H, Naik AM, Lee MC, Rosa M, Khazai L, Rendi MH, Lang JE, Lu J, Tawfik O, Asare SM, Esserman LJ, Mukhtar RA

Telecytology versus in-room Cytopathologist for Endoscopic Ultrasound Fine Needle Aspiration or Biopsy of Solid Pancreatic Lesions.

Gastrointestinal endoscopy

Kouanda A, Mclean R, Faggen A, Demissie E, Balassanian R, Kamal F, Avila P, Arain M, Dai SC, Munroe C

Interventional cytology benefits patients undergoing thyroid FNA.

Cancer cytopathology

Vohra P, Khanafshar E, Balassanian R

Treatment Efficacy Score - continuous residual cancer burden-based metric to compare neoadjuvant chemotherapy efficacy between randomized trial arms in breast cancer trials.

Annals of oncology : official journal of the European Society for Medical Oncology

Marczyk M, Mrukwa A, Yau C, Wolf D, Chen YY, Balassanian R, Nanda R, Parker BA, Krings G, Sattar H, Zeck JC, Albain KS, Boughey JC, Liu MC, Elias AD, Clark AS, Venters SJ, Shad S, Basu A, Asare SM, Buxton M, Asare AL, Rugo HS, Perlmutter J, DeMichele AM, Yee D, Berry DA, van 't Veer L, Symmans WF, Esserman L, Pusztai L, I-SPY Consortium

Standardizing Pathologic Evaluation of Breast Carcinoma After Neoadjuvant Chemotherapy.

Archives of pathology & laboratory medicine

Sahoo S, Krings G, Chen YY, Carter JM, Chen B, Guo H, Hibshoosh H, Reisenbichler E, Fan F, Wei S, Khazai L, Balassanian R, Klein ME, Shad S, Venters SJ, Borowsky AD, Symmans WF, Ocal IT

Global Cytopathology-Hematopathology Practice Trends.

American journal of clinical pathology

Zadeh SL, Balassanian R, Cheung MC, Falchi L, Hasserjian R, Lin O, Long SR, Ly A, Menke JR, Mou E, Natkunam Y, Ruiz-Cordero R, Volaric AK, Wang L, Wen KW, Gratzinger D

Corrigendum to: Global Cytopathology-Hematopathology Practice Trends.

American journal of clinical pathology

Zadeh SL, Balassanian R, Cheung MC, Falchi L, Hasserjian R, Lin O, Long SR, Ly A, Menke JR, Mou E, Natkunam Y, Ruiz-Cordero R, Volaric AK, Wang L, Wen KW, Gratzinger D

Assessment of Residual Cancer Burden and Event-Free Survival in Neoadjuvant Treatment for High-risk Breast Cancer: An Analysis of Data From the I-SPY2 Randomized Clinical Trial.

JAMA oncology

Symmans WF, Yau C, Chen YY, Balassanian R, Klein ME, Pusztai L, Nanda R, Parker BA, Datnow B, Krings G, Wei S, Feldman MD, Duan X, Chen B, Sattar H, Khazai L, Zeck JC, Sams S, Mhawech-Fauceglia P, Rendi M, Sahoo S, Ocal IT, Fan F, LeBeau LG, Vinh T, Troxell ML, Chien AJ, Wallace AM, Forero-Torres A, Ellis E, Albain KS, Murthy RK, Boughey JC, Liu MC, Haley BB, Elias AD, Clark AS, Kemmer K, Isaacs C, Lang JE, Han HS, Edmiston K, Viscusi RK, Northfelt DW, Khan QJ, Leyland-Jones B, Venters SJ, Shad S, Matthews JB, Asare SM, Buxton M, Asare AL, Rugo HS, Schwab RB, Helsten T, Hylton NM, van 't Veer L, Perlmutter J, DeMichele AM, Yee D, Berry DA, Esserman LJ

Utility and Outcomes of Preoperative Screening Breast MRI for Planned Bilateral Prophylactic Mastectomy in High-Risk Patients.

AJR. American journal of roentgenology

Taliaferro AS, Price ER, Hayward JH, Wong JM, Balassanian R, Fay JS, Freimanis RI, Joe BN, Lee AY

Impact of initial biopsy type on the time to final diagnostic biopsy in patients with follicular lymphoma and suspected histologic transformation.

Leukemia & lymphoma

Mou E, Falchi L, Sundaram V, Abramson JS, Balassanian R, Beygi S, Fitzpatrick MJ, Frank AK, Gupta S, Lin O, Reed JR, Long SR, Ly A, Menke JR, Reed DR, Ruiz-Cordero R, Volaric AK, Xie Y, Wang L, Wen KW, Zadeh SL, Natkunam Y, Cheung MC, Gratzinger D, Cyto-Heme Institutional Collaborative (CHIC) consortium

Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.

PloS one

Aklilu S, Bain C, Bansil P, de Sanjose S, Dunstan JA, Castillo V, Tsu V, Contreras I, Balassanian R, Hayes Constant TK, Scheel JR

Early onset, multiple, bilateral fibroadenomas of the breast: a case report.

BMC women's health

Im CJ, Miller A, Balassanian R, Mukhtar RA

Results from the 2019 American Society of Cytopathology survey on rapid onsite evaluation (ROSE)-part 2: subjective views among the cytopathology community.

Journal of the American Society of Cytopathology

Sauter JL, Chen Y, Alex D, Balassanian R, Cuda J, Flanagan MB, Griffith CC, Illei P, Johnson DN, McGrath CM, Randolph ML, Reynolds JP, Spiczka AJ, van Zante A, VanderLaan PA, American Society of Cytopathology Clinical Practice Committee

Cutaneous T-Cell Lymphoma PDX Drug Screening Platform Identifies Cooperation between Inhibitions of PI3Kα/δ and HDAC.

The Journal of investigative dermatology

Wu CH, Yang CY, Wang L, Gao HX, Rakhshandehroo T, Afghani S, Pincus L, Balassanian R, Rubenstein J, Gill R, Bandyopadhyay S, McCormick F, Moasser M, Ai WZ

Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer Is Associated with Indigenous American Ancestry in Latin American Women.

Cancer research

Marker KM, Zavala VA, Vidaurre T, Lott PC, Vásquez JN, Casavilca-Zambrano S, Calderón M, Abugattas JE, Gómez HL, Fuentes HA, Picoaga RL, Cotrina JM, Neciosup SP, Castañeda CA, Morante Z, Valencia F, Torres J, Echeverry M, Bohórquez ME, Polanco-Echeverry G, Estrada-Florez AP, Serrano-Gómez SJ, Carmona-Valencia JA, Alvarado-Cabrero I, Sanabria-Salas MC, Velez A, Donado J, Song S, Cherry D, Tamayo LI, Huntsman S, Hu D, Ruiz-Cordero R, Balassanian R, Ziv E, Zabaleta J, Carvajal-Carmona L, Fejerman L, COLUMBUS Consortium

Stop using expired plasma for cell blocks.

Cancer cytopathology

Balassanian R, Ng DL, van Zante A

Granulomatous inflammation diagnosed by fine-needle aspiration biopsy.

Journal of the American Society of Cytopathology

Ng DL, Balassanian R

Results from the 2019 American Society of Cytopathology survey on rapid on-site evaluation-Part 1: objective practice patterns.

Journal of the American Society of Cytopathology

VanderLaan PA, Chen Y, Alex D, Balassanian R, Cuda J, Hoda RS, Illei PB, McGrath CM, Randolph ML, Reynolds JP, Spiczka AJ, VandeHaar MA, van Zante A, Sauter JL, American Society of Cytopathology Clinical Practice Committee

Efficacy of an Intensive, Ultrasound-Guided Fine-Needle Aspiration Biopsy Training Workshop in Tanzania.

Journal of global oncology

Ng DL, Vuhahula E, Zhang L, Waterhouse EG, White KL, Mushi BP, Nyeriga MS, Philipo GS, Mmbaga EJ, Sheth S, Van Loon K, Lee AY, Balassanian R

Intratumor Heterogeneity of the Estrogen Receptor and the Long-term Risk of Fatal Breast Cancer.

Journal of the National Cancer Institute

Lindström LS, Yau C, Czene K, Thompson CK, Hoadley KA, Van't Veer LJ, Balassanian R, Bishop JW, Carpenter PM, Chen YY, Datnow B, Hasteh F, Krings G, Lin F, Zhang Y, Nordenskjöld B, Stål O, Benz CC, Fornander T, Borowsky AD, Esserman LJ, STO Trialists Group

Breast Cancer, Version 4.2017, NCCN Clinical Practice Guidelines in Oncology.

Journal of the National Comprehensive Cancer Network : JNCCN

Gradishar WJ, Anderson BO, Balassanian R, Blair SL, Burstein HJ, Cyr A, Elias AD, Farrar WB, Forero A, Giordano SH, Goetz MP, Goldstein LJ, Isakoff SJ, Lyons J, Marcom PK, Mayer IA, McCormick B, Moran MS, O'Regan RM, Patel SA, Pierce LJ, Reed EC, Salerno KE, Schwartzberg LS, Sitapati A, Smith KL, Smith ML, Soliman H, Somlo G, Telli ML, Ward JH, Kumar R, Shead DA

Tuberculosis mastitis presenting as bilateral breast masses.

Clinical imaging

Qiao Y, Hayward JH, Balassanian R, Ray KM, Joe BN, Lee AY

Radiologic-Pathologic Correlation for Benign Results After MRI-Guided Breast Biopsy.

AJR. American journal of roentgenology

Maglione KD, Lee AY, Ray KM, Joe BN, Balassanian R

NCCN Guidelines Insights: Breast Cancer, Version 1.2017.

Journal of the National Comprehensive Cancer Network : JNCCN

Gradishar WJ, Anderson BO, Balassanian R, Blair SL, Burstein HJ, Cyr A, Elias AD, Farrar WB, Forero A, Giordano SH, Goetz MP, Goldstein LJ, Isakoff SJ, Lyons J, Marcom PK, Mayer IA, McCormick B, Moran MS, O'Regan RM, Patel SA, Pierce LJ, Reed EC, Salerno KE, Schwartzberg LS, Sitapati A, Smith KL, Smith ML, Soliman H, Somlo G, Telli M, Ward JH, Shead DA, Kumar R

Fine-Needle Aspiration Biopsy of Palpable Breast Masses: Patterns of Clinical Use and Patient Experience.

Journal of the National Comprehensive Cancer Network : JNCCN

Ly A, Ono JC, Hughes KS, Pitman MB, Balassanian R

A superior method for cell block preparation for fine-needle aspiration biopsies.

Cancer cytopathology

Balassanian R, Wool GD, Ono JC, Olejnik-Nave J, Mah MM, Sweeney BJ, Liberman H, Ljung BM, Pitman MB

Invasive Breast Cancer Version 1.2016, NCCN Clinical Practice Guidelines in Oncology.

Journal of the National Comprehensive Cancer Network : JNCCN

Gradishar WJ, Anderson BO, Balassanian R, Blair SL, Burstein HJ, Cyr A, Elias AD, Farrar WB, Forero A, Giordano SH, Goetz M, Goldstein LJ, Hudis CA, Isakoff SJ, Marcom PK, Mayer IA, McCormick B, Moran M, Patel SA, Pierce LJ, Reed EC, Salerno KE, Schwartzberg LS, Smith KL, Smith ML, Soliman H, Somlo G, Telli M, Ward JH, Shead DA, Kumar R

NCCN Guidelines Insights Breast Cancer, Version 1.2016.

Journal of the National Comprehensive Cancer Network : JNCCN

Gradishar WJ, Anderson BO, Balassanian R, Blair SL, Burstein HJ, Cyr A, Elias AD, Farrar WB, Forero A, Giordano SH, Goetz M, Goldstein LJ, Hudis CA, Isakoff SJ, Marcom PK, Mayer IA, McCormick B, Moran M, Patel SA, Pierce LJ, Reed EC, Salerno KE, Schwartzberg LS, Smith KL, Smith ML, Soliman H, Somlo G, Telli M, Ward JH, Shead DA, Kumar R

"Score the Core" Web-based pathologist training tool improves the accuracy of breast cancer IHC4 scoring.

Human pathology

Engelberg JA, Retallack H, Balassanian R, Dowsett M, Zabaglo L, Ram AA, Apple SK, Bishop JW, Borowsky AD, Carpenter PM, Chen YY, Datnow B, Elson S, Hasteh F, Lin F, Moatamed NA, Zhang Y, Cardiff RD

Oncogenic activation of the PI3-kinase p110β isoform via the tumor-derived PIK3Cβ(D1067V) kinase domain mutation.

Oncogene

Pazarentzos E, Giannikopoulos P, Hrustanovic G, St John J, Olivas VR, Gubens MA, Balassanian R, Weissman J, Polkinghorn W, Bivona TG

Breast Cancer Version 2.2015.

Journal of the National Comprehensive Cancer Network : JNCCN

Gradishar WJ, Anderson BO, Balassanian R, Blair SL, Burstein HJ, Cyr A, Elias AD, Farrar WB, Forero A, Giordano SH, Goetz M, Goldstein LJ, Hudis CA, Isakoff SJ, Marcom PK, Mayer IA, McCormick B, Moran M, Patel SA, Pierce LJ, Reed EC, Salerno KE, Schwartzberg LS, Smith KL, Smith ML, Soliman H, Somlo G, Telli M, Ward JH, Shead DA, Kumar R

Gemtuzumab therapy for isolated extramedullary AML relapse following allogeneic stem-cell transplant.

Nature clinical practice. Oncology

Owonikoko T, Agha M, Balassanian R, Smith R, Raptis A

Effectiveness of Toyota process redesign in reducing thyroid gland fine-needle aspiration error.

American journal of clinical pathology

Raab SS, Grzybicki DM, Sudilovsky D, Balassanian R, Janosky JE, Vrbin CM

Clinical Experience With Mammary Ductoscopy.

Annals of surgical oncology

Valdes EK, Boolbol SK, Cohen JM, Balassanian R, Feldman SM

Errors in thyroid gland fine-needle aspiration.

American journal of clinical pathology

Raab SS, Vrbin CM, Grzybicki DM, Sudilovsky D, Balassanian R, Zarbo RJ, Meier FA

Improving the quality of cytology diagnosis: root cause analysis for errors in bronchial washing and brushing specimens.

American journal of clinical pathology

Nodit L, Balassanian R, Sudilovsky D, Raab SS

Diagnosis of recurrent breast cancer by ductoscopy.

The breast journal

Valdes EK, Feldman SM, Balassanian R, Cohen JM, Boolbol SK

Association of breast cancer with papillary lesions identified at percutaneous image-guided breast biopsy.

American journal of surgery

Gendler LS, Feldman SM, Balassanian R, Riker MA, Frencher SK, Whelan DB, Anne S, Gross JD, Cohen JM, Boolbol SK

Donor origin of neuroendocrine carcinoma in 2 transplant patients determined by molecular cytogenetics.

Human pathology

Baehner R, Magrane G, Balassanian R, Chang C, Millward C, Wakil AE, Osorio RW, Waldman FM