A bone marrow biopsy is a procedure that takes a small sample of the marrow inside your bones for testing in a laboratory. This test is used to see if you have an infection, disease, or other problem in your bone marrow.
Bone marrow is the spongy tissue found inside your bones. In the larger bones— such as your spine, breastbone, hips, ribs, legs, or skull—bone marrow contains cells that produce white blood cells, red blood cells, and platelets. Your white blood cells help fight infection, your red blood cells carry oxygen and nutrients, and your platelets enable the blood to clot.
Marrow has both solid and liquid parts. If the solid portion of the bone is sampled, this is called a biopsy. Aspiration is the procedure used to collect the liquid part of the marrow.
Problems with bone marrow can create lasting, serious health concerns. A bone marrow biopsy is one of many tests that can be done to check the cells of your bone marrow for problems.
Numerous conditions are associated with unhealthy bone marrow. If blood tests show low levels of platelets or white or red blood cells, your doctor may order a bone marrow biopsy.
This test also allows your doctor to check for a suspected disease, see how far a disease has progressed, or monitor the effects of a treatment method.
According to the Mayo Clinic, conditions and diseases that can affect your bone marrow include:
- anemia, or a low red blood cell count
- bone marrow diseases, such as myelofibrosis or myelodysplastic syndrome
- blood cell conditions, such as leukopenia or polycythemia
- cancers of the bone marrow or blood, such as leukemias or lymphomas
- hemochromatosis, a genetic disorder in which iron builds in the blood
- infection, such as sepsis
A bone marrow biopsy is also an important test if you are undergoing cancer treatment, since it can help determine if the cancer has spread to your bones. (Mayo Clinic, 2011)
All medical procedures carry some type of risk. The Mayo Clinic states that bone marrow exams are safe. (Mayo Clinic, 2011)
However in some rare instances, the following complications are possible:
- allergic reaction to anesthesia
- excessive bleeding
- long-lasting discomfort at the spot where the biopsy was taken
These risks are rare and most often occur among people who have other conditions that weaken their immune systems or lower their platelet counts.
Your doctor will perform several examinations prior to the biopsy. During these tests, be sure to tell your doctor about any medications you take—including over-the-counter medicines or nutritional supplements—and any known allergies you have.
Your doctor may ask you to stop taking certain medications prior to the procedure. Never stop taking a medication unless your doctor instructs you to do so.
Tell your doctor if you are nervous. He or she may give you a mild sedative to help you through your procedure.
Follow all of your doctor’s instructions before the procedure. Do not forget to show up on time for your biopsy. You may also want to arrange for a ride home.
Before the test, you will be asked to change into a hospital gown. Then you will sit on your side or lie on your belly in a room where the procedure will take place.
A doctor or nurse will give you a local anesthesia to numb the area where the biopsy will be taken. Typically this will be at the top ridge of your rear hipbone. Occasionally it may be taken from your chest bone.
You might feel a brief sting as the anesthesia is injected.
Your doctor will make a small incision so a hollow needle can easily get past the skin. The needle then goes into the bone. It collects a cylinder-shaped sample known as a core sample.
According to the National Institutes of Health, some people feel a dull pain or discomfort as the biopsy is taken, since the inside of your bones cannot be numbed. However, not everyone will experience this. (NIH, 2010)
Immediately after the procedure, the incision will be bandaged, and you will be taken into another room to rest before going home.
You may feel some slight pain for about a week after the procedure. This is easily managed with over-the-counter pain relievers. You will also need to care for the incision wound, which involves keeping it dry for 24 hours after the biopsy.
While you are caring for your wound, your bone marrow sample will be sent to a laboratory for testing. Once the results are back, your doctor may call you or have you come to his or her office for a follow-up appointment to discuss the findings.
Abnormal results may be due to cancer, anemia, or another condition. Your doctor may need to order more tests to confirm a diagnosis or to see how far the condition has gone. He or she will discuss your treatment options with you and help you plan your next steps during your follow-up appointment.