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Bone Marrow Biopsy: Why It Is Done and What to Expect
By Dr. Gajendra Kumar Himanshu
A bone marrow biopsy is a medical test in which a small sample of bone marrow and a small piece of bone are removed, usually from the back of the hip, and examined in a laboratory. Doctors use this test to look for abnormal blood or bone marrow cells and to help diagnose or monitor conditions such as blood cancers, some other cancers, and certain blood disorders. A bone marrow biopsy is often done together with a bone marrow aspiration, which collects the liquid part of the marrow.
Being told that you need a bone marrow biopsy can naturally cause worry, especially if you are being checked for cancer. However, knowing what happens before, during, and after the procedure can make it easier to prepare.
In this blog, we will explain why doctors recommend a bone marrow biopsy, how it is performed, what the test may feel like, how to prepare, possible risks, and what recovery is usually like.
What Is a Bone Marrow Biopsy?
Bone marrow is the soft, sponge-like tissue inside some of the body's larger bones. It makes important blood cells, including red blood cells, white blood cells, and platelets.
During a bone marrow biopsy, a doctor removes a small piece of bone containing bone marrow. The sample is then sent to a laboratory where a pathologist examines it under a microscope. Doctors commonly take the biopsy from the back of the hip bone.
A biopsy is different from a normal blood test because it allows doctors to examine the place where blood cells are made. This can provide information that cannot always be obtained from blood tests alone.
If you want to understand why doctors use different types of biopsies to diagnose cancer, you can also read this helpful guide on types of biopsy tests.
Why Is a Bone Marrow Biopsy Done?
Doctors may recommend a bone marrow biopsy when blood tests show an unusual result or when they need more information about a suspected blood or bone marrow condition. It may also be used to monitor an existing disease or check how treatment is working.
A bone marrow biopsy may help doctors:
- Diagnose some blood cancers and bone marrow disorders.
- Find out why blood cell counts are unusually high or low.
- Check whether cancer has affected the bone marrow.
- Understand the type or extent of certain blood diseases.
- Monitor how a disease is responding to treatment.
Conditions that may require a bone marrow examination include some types of leukaemia, lymphoma, multiple myeloma, myelodysplastic syndromes, and other blood disorders.
For more information about how doctors confirm cancer, you can read about cancer diagnosis.
Bone Marrow Aspiration vs Biopsy
Bone marrow aspiration and bone marrow biopsy are often performed during the same appointment, but they collect different samples. Aspiration removes a small amount of the liquid part of the bone marrow using a syringe, while a biopsy removes a small, solid piece of bone and marrow. Looking at both samples can give doctors more complete information about the bone marrow.
Procedure | What is removed? | Why it is useful |
|---|---|---|
Bone marrow aspiration | Liquid bone marrow | Looks at individual marrow cells |
Bone marrow biopsy | Small piece of bone and marrow | Shows the structure and amount of marrow |
Both together | Liquid and solid samples | Gives a more complete picture of the bone marrow |
Your doctor will decide whether you need one test or both based on your symptoms, blood results, and suspected condition.
How Should You Prepare for a Bone Marrow Biopsy?
Your healthcare team will tell you how to prepare based on the type of procedure and whether sedation will be used.
Before the procedure, tell your doctor about all medicines and supplements you take. It is especially important to mention blood-thinning medicines because they may affect bleeding risk.
Your doctor may also ask about allergies, previous problems with anaesthesia or sedation and other health conditions.
What Happens During the Procedure?
A bone marrow biopsy is usually performed in a hospital, clinic, or doctor's office. The procedure itself commonly takes around 10 to 20 minutes, although preparation and recovery can take additional time.
You will usually lie on your side or stomach. The healthcare professional cleans the area on the back of your hip and gives a local anaesthetic to numb the skin and tissue.
A special needle is then guided through the skin and into the hip bone. If an aspiration is also being done, a syringe removes a small amount of liquid marrow. The biopsy needle then collects a small core of bone and marrow.
You may feel pressure during the procedure. During aspiration, some people experience a brief sharp or pulling pain. Sedation may be offered in some situations to help reduce discomfort or anxiety.
Is a Bone Marrow Biopsy Painful?
People experience the procedure differently. The local anaesthetic helps numb the area, but you may still feel pressure when the needle enters the bone. Aspiration can cause a brief, sharp sensation because the liquid marrow is removed.
If you are worried about pain, tell your doctor before the procedure. Your healthcare team can discuss pain relief or sedation options that may be appropriate for you.
After the procedure, the biopsy area may feel sore or tender for several days. Some people may have tenderness for a week or longer.
What Happens After a Bone Marrow Biopsy?
After the sample is collected, pressure is applied to the area to help stop bleeding, and a bandage is placed over the site. If only local anaesthesia was used, many people can leave soon after the procedure and return to normal activities when they feel ready.
You should follow the instructions given by your healthcare team. In many cases, patients are advised to keep the bandage dry for 24 hours and to avoid strenuous activity for a day or two.
Mild soreness at the biopsy site is common. Your doctor can advise you about suitable pain relief if needed.
What Are the Possible Risks?
Bone marrow biopsy is generally considered a safe procedure, but like any medical procedure, it can have some risks.
Possible problems include:
- Bleeding at the biopsy site
- Infection
- Pain or tenderness
- Bruising or swelling
Serious complications are uncommon. Contact your healthcare team if you have heavy or persistent bleeding, increasing pain, swelling, redness, drainage, or fever after the procedure.
When Will You Get the Results?
The sample is sent to a laboratory where specialists examine the bone marrow. Additional laboratory tests may also be performed on the sample, depending on what doctors are looking for. These can include tests that examine chromosomes or other features of abnormal cells.
The time needed for results can vary because different tests may take different amounts of time. Your doctor will explain the results and discuss whether further tests or treatment are needed.
A biopsy result does not always mean that cancer is present. The test may be performed to investigate abnormal blood counts or other conditions as well.
If you want to read more about bone marrow, you can visit the National Cancer Institute.
Consult Today
A bone marrow biopsy can provide important information when doctors need to understand what is happening inside the bone marrow. Although the procedure may sound uncomfortable, it is usually a short procedure, and the area is numbed before the sample is taken.
At Oncare Cancer Hospital, patients can discuss abnormal blood counts, suspected blood cancers, biopsy tests, and treatment options with a cancer care team. If your doctor has recommended a bone marrow biopsy, understanding why it is needed and what to expect can help you feel more prepared.
If you have questions about your biopsy report or need guidance after receiving an abnormal blood test, speak with a cancer specialist for an individual evaluation.
Disclaimer
This information is for educational purposes only and does not constitute medical advice, diagnosis, or treatment. The need for a bone marrow biopsy and the meaning of its results depend on each patient's condition. Always discuss tests, reports, and treatment decisions with a certified cancer healthcare provider.
Frequently Asked Questions
You may feel pressure and brief pain during aspiration. Local anaesthesia is used to numb the area, and sedation may be available in some cases.
The procedure itself commonly takes about 10 to 20 minutes, although preparation and recovery may take longer.
It is usually taken from the back of the hip bone, also called the posterior iliac crest.
No, it can be used to investigate abnormal blood counts, blood disorders, unexplained problems, and to monitor certain conditions as well as cancer.
Written and Verified by:
Dr. Gajendra Kumar Himanshu Exp: 10 Yr
Medical Officer
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