What You Need to Know About Bone Marrow Biopsy

What is a bone marrow biopsy?

A bone marrow biopsy is typically a 60-minute medical procedure. Bone marrow is the spongy tissue present within your bones. It houses the blood vessels. It also houses the stem cells that facilitates the production of:

• Bone
• Cartilage
• Fat
• Platelets
• Red blood cells and white blood cells

There are two types of marrow in the human bone: the red marrow and the yellow marrow. Red marrow is found in flat bones (for example, the hip and vertebrae). Your marrow becomes more yellow as you get older due to the increasing number of fat cells. So, what will your doctor do? First, they will extract your red marrow from the back of your hip bone in most cases. Then, this red marrow will be analyzed for any blood cell abnormalities.

The lab will analyze your marrow to see if it produces healthy blood cells. If it isn’t, they will try to find out the cause (which may be an infection, cancer, or a disease of the bone marrow).

Why is a bone marrow biopsy done?

A bone marrow biopsy or examination gives detailed information about the health of your bone marrow and your blood cells.

Your healthcare provider may ask you to do a bone marrow examination if blood tests aren’t standard or do not provide enough information about an underlying condition.

A bone marrow biopsy may help to:

• Diagnose a health condition or disease involving blood cells or the bone marrow
• Determine the stage of an illness or how fast it is progressing
• Determine whether the iron levels in your blood are adequate or not
• Investigate a fever of unknown origin

A bone marrow biopsy may be used for many health conditions. Examples include:

• Anemia
• There are blood cell conditions in which too few or too many blood cells are produced. Examples of such conditions include leukocytosis, thrombocytopenia, polycythemia, pancytopenia, and thrombocytosis.
• Bone marrow or blood cancers, including lymphomas, leukemias, and multiple myeloma.
• Cancers have spread across a wide area, such as from the breast into the bone marrow.
• Fevers with unknown origin

Risks associated with a bone marrow biopsy

There is some form of risk associated with every medical procedure. However, bone marrow complications are pretty rare. According to the British Society of Hematology, less than one percent of bone marrow test results resulted in adverse events. Instead, bleeding is the leading risk associated with this procedure. Hemorrhage is also known as excessive bleeding.

Other complications associated with this procedure include:

• Infection
• Allergic reaction to anesthesia
• Persistent pain at the site of biopsy

Consult your healthcare provider if you have an underlying health condition or are taking medication, significantly if it increases your risk for bleeding.

Preparing for a bone marrow biopsy

A bone marrow exam is often done on an outpatient basis. So, there’s usually no need for any special preparation.

If you are sedated during the exam, your healthcare provider may ask that you refrain from eating for some time before the procedure. You will also arrange for someone to take you home after the process.

You should also:

• Tell your healthcare provider about any supplements and medications you take. For example, some meds can increase your risk of bleeding after a bone marrow biopsy or aspiration.
• Discuss with your doctor if you are nervous about your biopsy. In some cases, the patient may be given a sedative before the exam, in addition to local anesthesia at the site of the biopsy.

Is a bone marrow biopsy painful?

A biopsy pain is reported to be average, short-lived, and not as severe as anticipated. According to some studies, the pain of biopsy is linked to the duration and difficulty of the procedure. The pain is usually less if the biopsy is completed within ten minutes.

Another factor that affects determines the severity of pain is your anxiety level. People who understand bone marrow biopsy usually experience lesser pain than others.

How is a bone marrow biopsy performed?

A bone marrow test can be performed in a clinic, in your doctor’s office, or at a hospital. An oncologist or a hematologist usually performs the procedure. An oncologist is a doctor who specializes in cancer. A hematologist is a doctor who specializes in blood disorders. The biopsy itself is typically a ten-minute procedure.

Before the procedure, you will change into a hospital gown. First, your blood pressure and heart rate will be checked. Then, you will be asked to lie on your stomach or sit on your side. After that, a local anesthetic will be applied to the skin and the bone to numb the test area. Most biopsies are taken from the chest bone or the ridge of the rear hipbone.

You will feel some sting as your doctor injects the anesthetic. Then a tiny incision will be made to allow easy passage of a hollow needle through your skin.

The needle will penetrate the bone and harvest the red marrow. However, the hand will not come anywhere near your spinal cord. Therefore, you may feel some discomfort or dull pain as the needle penetrates your bone.

After the biopsy, your doctor will apply pressure to the treated area to stop bleeding and bandage the spot.

What do your bone marrow biopsy results mean?

The primary purpose of a biopsy is to determine whether your bone marrow is functioning as it should or not. If it isn’t working at optimal levels, your healthcare provider will determine why. First, a sample of your marrow will be examined by a pathologist. Then, they will perform a couple of tests to help determine the underlying cause of any abnormalities.

If you have a specific type of cancer, such as lymphoma, a biopsy will help stage cancer by determining whether cancer has affected the bone marrow or not.

Abnormal results may be attributed to an infection, cancer, or another disease of the bone marrow. Your healthcare provider may order some more tests to confirm your diagnosis. The results and treatment options will be discussed and the next steps planned during the follow-up appointment.

Ifiokobong Ene

Ifiokobong Ene is a Medical Physiologist, and a freelance medical writer. Ifiok brings his years of medical research experience to help consistently create high-quality, and engaging articles and products that uphold the highest medical standards. He is dedicated to making health and wellness information available, actionable, and understandable so that readers can make the best decisions about their health.