Ron Balassanian, MD
Professor
Pathology
School of Medicine

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.

• Wilms Tumor: An Unexpected Diagnosis in Adult Patients.
  Archives of pathology & laboratory medicine 2024 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 2024 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 2024 Fitzhugh VA, Reynolds JP, Flanagan M, Balassanian R
• Cytopathology in the era of social media.
  Diagnostic cytopathology 2024 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 2024 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 2024 Khorsandi N, Balassanian R, Vohra P
• Utility and performance of cell blocks in urine cytology: Experience at three teaching hospitals.
  Cancer cytopathology 2023 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 2023 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 2022 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…
• 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 2022 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 …
• Association of Residual Ductal Carcinoma In Situ With Breast Cancer Recurrence in the Neoadjuvant I-SPY2 Trial.
  JAMA surgery 2022 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, …
• Telecytology versus in-room cytopathologist for EUS-guided FNA or fine-needle biopsy sampling of solid pancreatic lesions.
  Gastrointestinal endoscopy 2022 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 2022 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 2022 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, …
• Standardizing Pathologic Evaluation of Breast Carcinoma After Neoadjuvant Chemotherapy.
  Archives of pathology & laboratory medicine 2022 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
• Limitations and opportunities for tumor infiltrating lymphocytes in breast FNA.
  Cancer cytopathology 2022 Balassanian R, Vohra P
• Global Cytopathology-Hematopathology Practice Trends.
  American journal of clinical pathology 2022 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 2022 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 2021 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, …
• Utility and Outcomes of Preoperative Screening Breast MRI for Planned Bilateral Prophylactic Mastectomy in High-Risk Patients.
  AJR. American journal of roentgenology 2021 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 2021 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…
• Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru.
  PloS one 2021 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 2021 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 2020 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 …
• Cutaneous T-Cell Lymphoma PDX Drug Screening Platform Identifies Cooperation between Inhibitions of PI3Kα/δ and HDAC.
  The Journal of investigative dermatology 2020 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 2020 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, …
• Stop using expired plasma for cell blocks.
  Cancer cytopathology 2019 Balassanian R, Ng DL, van Zante A
• Granulomatous inflammation diagnosed by fine-needle aspiration biopsy.
  Journal of the American Society of Cytopathology 2019 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 2019 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 …
• Efficacy of an Intensive, Ultrasound-Guided Fine-Needle Aspiration Biopsy Training Workshop in Tanzania.
  Journal of global oncology 2018 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
• Improved diagnostic precision of urine cytology by implementation of The Paris System and the use of cell blocks.
  Cancer cytopathology 2018 Chan E, Balassanian R, Tabatabai ZL, Lou H, Vohra P
• Intratumor Heterogeneity of the Estrogen Receptor and the Long-term Risk of Fatal Breast Cancer.
  Journal of the National Cancer Institute 2018 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, …
• Breast Cancer, Version 4.2017, NCCN Clinical Practice Guidelines in Oncology.
  Journal of the National Comprehensive Cancer Network : JNCCN 2018 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…
• Tuberculosis mastitis presenting as bilateral breast masses.
  Clinical imaging 2018 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 2017 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 2017 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…
• Fine-Needle Aspiration Biopsy of Palpable Breast Masses: Patterns of Clinical Use and Patient Experience.
  Journal of the National Comprehensive Cancer Network : JNCCN 2016 Ly A, Ono JC, Hughes KS, Pitman MB, Balassanian R
• A superior method for cell block preparation for fine-needle aspiration biopsies.
  Cancer cytopathology 2016 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 2016 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…
• NCCN Guidelines Insights Breast Cancer, Version 1.2016.
  Journal of the National Comprehensive Cancer Network : JNCCN 2015 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…
• "Score the Core" Web-based pathologist training tool improves the accuracy of breast cancer IHC4 scoring.
  Human pathology 2015 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 2015 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 2015 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…
• Gemtuzumab therapy for isolated extramedullary AML relapse following allogeneic stem-cell transplant.
  Nature clinical practice. Oncology 2007 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 2006 Raab SS, Grzybicki DM, Sudilovsky D, Balassanian R, Janosky JE, Vrbin CM
• Clinical Experience With Mammary Ductoscopy.
  Annals of surgical oncology 2006 Valdes EK, Boolbol SK, Cohen JM, Balassanian R, Feldman SM
• Errors in thyroid gland fine-needle aspiration.
  American journal of clinical pathology 2006 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 2005 Nodit L, Balassanian R, Sudilovsky D, Raab SS
• Diagnosis of recurrent breast cancer by ductoscopy.
  The breast journal 2005 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 2004 Gendler LS, Feldman SM, Balassanian R, Riker MA, Frencher SK, Whelan DB, Anne S, Gross JD, Cohen JM, Boolbol SK
• Increased engraftment and GVHD after in utero transplantation of MHC-mismatched bone marrow cells and CD80low, CD86(-) dendritic cells in a fetal mouse model.
  Transplantation 2001 Chou SH, Chawla A, Lee TH, Zhou Y, Busch MP, Balassanian R, Ferrell L, Cowan MJ
• Donor origin of neuroendocrine carcinoma in 2 transplant patients determined by molecular cytogenetics.
  Human pathology 2000 Baehner R, Magrane G, Balassanian R, Chang C, Millward C, Wakil AE, Osorio RW, Waldman FM