Research Summary

Dr. Ronald Balassanian is a pathologist in the UCSF Fine Needle Aspiration (FNA) Biopsy Clinic at the Bakar Precision Cancer Medicine Building at Mission Bay. In his research, Dr. 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.

Dr. 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.

Dr. 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.


University of Washington, Seattle, BS, 06/89, Cell Biology
University of Washington, Seattle, BA, 06/89, English Literature
University of Vermont, Burlington, College of Medicine, MD, 05/96, Surgery major
University of Vermont, Burlington, Pathology, Student fellow, 12/94, Pathology
New York University, New York, PGY1 Resident, 06/97, Pathology
University of California San Francisco, Resident, 06/98, Pathology
University of California San Francisco, Resident, 06/99, Pathology & Lab Med
University of California San Francisco, Fellow, 06/00, Surgical Pathology
University of California San Francisco, Fellow, 06/01, Cytopathology
University of California San Francisco, Chief Resident, 12/00, Pathology
University of California San Francisco, Resident, 06/02, Laboratory Medicine

Honors & Awards

  • 1991
    Honorary Technical Consultant, Cancer Information Service of the Pacific, National Cancer Institute, Fred Hutchinson Cancer Research Center, Seattle, Washington
  • 1995
    Robert Larner, M.D. Medical Student Loan Fund Award, University of Vermont, College of Medicine
  • 1996
    James E. Demeules Surgical Research Prize, University of Vermont College of Medicine, Department of Surgery
  • 1998
    "Medical Student Teaching Award", University of California, San Francisco, Department of Pathology
  • 2010
    "Excellence in Teaching Award in Anatomic Pathology", Massachusetts General Hospital, Department of Pathology , Residents and Fellows
  • 2007
    "Outstanding Teaching in Anatomic Pathology", University of Pittsburgh, Department of Pathology, Residents and Fellows

Selected Publications

  1. 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, Veer LV, Symmans WF, Esserman L, Pusztai L, I-SPY Consortium. Treatment Efficacy Score-continuous residual cancer burden-based metric to compare neoadjuvant chemotherapy efficacy between randomized trial arms in breast cancer trials. Ann Oncol. 2022 08; 33(8):814-823.  View on PubMed
  2. Balassanian R, Vohra P. Limitations and opportunities for tumor infiltrating lymphocytes in breast FNA. Cancer Cytopathol. 2022 05; 130(5):328-329.  View on PubMed
  3. 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. Global Cytopathology-Hematopathology Practice Trends. Am J Clin Pathol. 2022 Feb 03; 157(2):196-201.  View on PubMed
  4. 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. Am J Clin Pathol. 2022 Jan 06; 157(1):155.  View on PubMed
  5. 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. 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 Oncol. 2021 Nov 01; 7(11):1654-1663.  View on PubMed
  6. Taliaferro AS, Price ER, Hayward JH, Wong JM, Balassanian R, Fay JS, Freimanis RI, Joe BN, Lee AY. Utility and Outcomes of Preoperative Screening Breast MRI for Planned Bilateral Prophylactic Mastectomy in High-Risk Patients. AJR Am J Roentgenol. 2022 02; 218(2):241-248.  View on PubMed
  7. 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. Impact of initial biopsy type on the time to final diagnostic biopsy in patients with follicular lymphoma and suspected histologic transformation. Leuk Lymphoma. 2021 12; 62(12):2864-2872.  View on PubMed
  8. Aklilu S, Bain C, Bansil P, de Sanjose S, Dunstan JA, Castillo V, Tsu V, Contreras I, Balassanian R, Hayes Constant TK, Scheel JR. Evaluation of diagnostic ultrasound use in a breast cancer detection strategy in Northern Peru. PLoS One. 2021; 16(6):e0252902.  View on PubMed
  9. Im CJ, Miller A, Balassanian R, Mukhtar RA. Early onset, multiple, bilateral fibroadenomas of the breast: a case report. BMC Womens Health. 2021 04 21; 21(1):170.  View on PubMed
  10. 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. Results from the 2019 American Society of Cytopathology survey on rapid onsite evaluation (ROSE)-part 2: subjective views among the cytopathology community. J Am Soc Cytopathol. 2020 Nov - Dec; 9(6):570-578.  View on PubMed
  11. 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. Cutaneous T-Cell Lymphoma PDX Drug Screening Platform Identifies Cooperation between Inhibitions of PI3Kα/δ and HDAC. J Invest Dermatol. 2021 02; 141(2):364-373.  View on PubMed
  12. 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. Human Epidermal Growth Factor Receptor 2-Positive Breast Cancer Is Associated with Indigenous American Ancestry in Latin American Women. Cancer Res. 2020 05 01; 80(9):1893-1901.  View on PubMed
  13. Balassanian R, Ng DL, van Zante A. Stop using expired plasma for cell blocks. Cancer Cytopathol. 2019 12; 127(12):737-738.  View on PubMed
  14. Ng DL, Balassanian R. Granulomatous inflammation diagnosed by fine-needle aspiration biopsy. J Am Soc Cytopathol. 2019 Nov - Dec; 8(6):317-323.  View on PubMed
  15. 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. Results from the 2019 American Society of Cytopathology survey on rapid on-site evaluation-Part 1: objective practice patterns. J Am Soc Cytopathol. 2019 Nov - Dec; 8(6):333-341.  View on PubMed
  16. 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. Efficacy of an Intensive, Ultrasound-Guided Fine-Needle Aspiration Biopsy Training Workshop in Tanzania. J Glob Oncol. 2018 10; 4:1-9.  View on PubMed
  17. Chan E, Balassanian R, Tabatabai ZL, Lou H, Vohra P. Improved diagnostic precision of urine cytology by implementation of The Paris System and the use of cell blocks. Cancer Cytopathol. 2018 09; 126(9):809-816.  View on PubMed
  18. 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. Intratumor Heterogeneity of the Estrogen Receptor and the Long-term Risk of Fatal Breast Cancer. J Natl Cancer Inst. 2018 07 01; 110(7):726-733.  View on PubMed
  19. 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. Breast Cancer, Version 4.2017, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2018 Mar; 16(3):310-320.  View on PubMed
  20. Qiao Y, Hayward JH, Balassanian R, Ray KM, Joe BN, Lee AY. Tuberculosis mastitis presenting as bilateral breast masses. Clin Imaging. 2018 Nov - Dec; 52:28-31.  View on PubMed

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