A bone marrow biopsy is a medical procedure that collects a small sample of bone marrow, the soft tissue found inside certain bones. This sample is analyzed to assess the health and function of the bone marrow. The procedure helps doctors diagnose various conditions affecting the blood and bone marrow, where the body’s blood cells are produced. It provides information not always obtainable from a standard blood test, identifying potential diseases or abnormalities within the marrow.
Why a Bone Marrow Biopsy is Performed
Doctors often recommend a bone marrow biopsy to investigate abnormal routine blood test results, such as unusually high or low levels of red blood cells, white blood cells, or platelets. This procedure also diagnoses and stages various blood cancers, including leukemias, lymphomas, and multiple myeloma. A biopsy can reveal if cancer originating elsewhere in the body, such as breast or prostate cancer, has spread to the bone marrow. It also helps assess non-cancerous conditions like anemia, myelofibrosis, or myelodysplastic syndromes. Doctors may also use the biopsy to investigate unexplained fevers or infections, and to monitor the effectiveness of ongoing treatments for blood-related disorders.
Preparing for Your Biopsy
Preparation for a bone marrow biopsy involves several steps. Discuss all medications with your doctor, particularly blood thinners, which may need to be temporarily stopped. Inform the medical team about any allergies, especially to local anesthetics or latex. Instructions regarding food and drink will be provided; fasting may be required if sedation is used. If receiving sedation, arrange for someone to drive you home afterward, as you will not be able to operate a vehicle.
What Happens During the Procedure
During a bone marrow biopsy, you will typically lie on your side or stomach to allow access to the hip bone, the most common site. The medical team will clean the area with an antiseptic solution to minimize infection risk. A local anesthetic is then injected into the skin and down to the bone, numbing the area. While the anesthetic helps manage pain, you might still feel pressure during the injection.
Once the area is numb, the doctor will make a small incision. The procedure usually involves two parts: a bone marrow aspiration and a bone marrow biopsy. For aspiration, a specialized needle is inserted into the marrow cavity, and a syringe withdraws a liquid sample. Patients often describe a brief, sharp pulling or sucking sensation as the liquid marrow is extracted.
Following aspiration, a slightly larger, hollow needle collects a solid piece of bone marrow tissue, known as a core biopsy. This needle is advanced into the bone with a twisting motion to capture the cylindrical tissue sample. During the core biopsy, you might experience pressure or a dull ache. The entire collection process, after preparation, typically takes about 10 to 15 minutes.
After Your Bone Marrow Biopsy
Immediately after the procedure, pressure will be applied to the biopsy site for several minutes to stop bleeding. A sterile dressing or bandage will then be placed over the wound. You will typically be asked to lie flat for a short period, often 5 to 10 minutes, to further aid clotting.
Some soreness or aching at the biopsy site for a few days is common. Over-the-counter pain relievers, such as acetaminophen, can help manage this discomfort. Keep the dressing clean and dry, and avoid strenuous activities or heavy lifting for 24 to 48 hours to allow the site to heal. Monitor the biopsy site for complications like excessive bleeding, increasing pain, swelling, redness, or fever, and contact your doctor if these occur.
Understanding Your Biopsy Results
Once bone marrow samples are collected, they are sent to a specialized laboratory for analysis. Pathologists and other specialists examine the liquid aspirate and solid core biopsy under a microscope. They look for abnormalities in cell structure, quantity, and maturity, and can perform various tests such as genetic analysis or flow cytometry.
The time to receive results varies, typically ranging from several days to a few weeks, depending on test complexity. Once analysis is complete, your doctor will discuss the findings, explaining what the results mean for your health. This conversation will clarify the diagnosis, determine disease extent, or assess treatment effectiveness.