Doctors use a bone marrow biopsy to check the health of blood cells. They insert a small needle into a large bone to take a sample of the bone marrow, which will then be sent to a laboratory. This remarkable medical test provides insights on whether a person has blood and marrow diseases, including some cancers.
Who needs a bone marrow biopsy?
Your primary care physician may order a biopsy if your blood tests show abnormally high or low levels of red or white blood cells, and platelets. The procedure will help determine the cause of these irregularities, which can include:
- Blood cell disorders, such as polycythemia, thrombocytopenia, or leukopenia
- Abnormal bleeding or clotting
- Anemia or a low red blood cell count
- Bone marrow diseases, such as myelodysplastic syndrome or myelofibrosis
- Hemochromatosis, a genetic disorder in which iron forms in the blood
- Cancers of the blood or bone marrow, such as lymphomas or leukemia
These conditions can influence your blood cell production and the levels of your blood cell types. Another possible reason why you may have to go through a bone marrow test is to determine the stage of a cancer, how far a disease has advanced, or to regulate the effects of treatment.
What to expect
You may take the test in a clinic, a hospital, or in your doctor’s office. The procedure itself takes about 10 minutes, but the total time spent can last for 30 to 60 minutes.
To ensure your safety and comfort, your healthcare provider will discuss your medical history and other concerns before the biopsy. You should tell your doctor about the following:
- Any supplements or medication you are taking
- Any history of diseases, especially if you’ve had bleeding disorders
- If you are pregnant or you think you might be
- Any allergies or sensitivities to anesthesia, tape, or other substances
- If you need medication to help ease your anxiety
Doctors often recommend having a friend or a family member to accompany the patient on the day of the biopsy. There are cases when extra medication like sedatives may be used, so it helps if there is someone to take care of you after the procedure. You shouldn’t drive after taking a relaxant because it can make you feel drowsy.
Your physician may ask you to stop taking certain drugs beforehand, so be sure to follow instructions like this carefully. In addition, getting a good night’s sleep before the day of your appointment may help you feel less tense.
During the procedure
Healthcare providers have various ways of carrying out a bone marrow biopsy, but the process generally takes two steps:
- Aspiration – The doctor takes away fluid from the bone marrow
- Biopsy – Extraction of a small piece of the bone and bone marrow tissue
The procedure is normally done on an outpatient basis, but some patients take it while in the hospital. While the pelvic bone is the most common source for the biopsy, other bones may still be used. The patient changes into a gown before the biopsy. The doctor will ask the patient to lie on their stomach or side, depending on the biopsy site. They will then proceed to clean the biopsy area with an antiseptic.
To numb the area, the doctor will apply an anesthetic with a needle. There may be some pain while the anesthetic is being released into the site. Once the area is numb, the doctor will create a tiny incision and carry out the bone marrow aspiration.
A syringe will be used to get a liquid sample of the bone marrow cells. After this step, the physician will now perform the bone marrow biopsy. Expect a larger needle than the one used during the aspiration. The doctor will guide this needle into the bone, rotate it, and then take away a sample of tissue and bone.
After the biopsy
Most people do not experience any pain a week after the procedure, but it can happen to some. To manage any residual pain, your doctor may recommend over-the-counter pain relievers like acetaminophen or ibuprofen. You will also need to tend for the incision wound. Be sure to keep it dry for 24 hours after the biopsy.
For about one or two days, avoid strenuous activities to prevent the wound from opening. If you experience fever, swelling, increased pain, drainage, or excess bleeding, contact your doctor immediately. Waiting for the bone marrow test results may take one to three weeks. Your physician will then call to schedule a follow-up appointment to discuss the findings.
Complications may arise to any medical procedure, but the risks of a bone marrow biopsy are extremely rare. The British Society of Haematology revealed that only less than one percent of bone marrow exams had adverse outcomes. Hemorrhage or excessive bleeding is the main risk for the procedure, but other reported complications include infection, allergic reaction to anesthesia, and persistent pain in the biopsy site.
During your consultation, your doctor will evaluate your health condition and consider factors that might increase your risk for certain complications, especially for bleeding.
The main purpose of the biopsy is to learn whether your bone marrow is working as it should, and if not, to identify the problem. A pathologist will examine your sample and perform several tests to help find the cause of any abnormalities.
For those who are suffering from a certain type of cancer like lymphoma, the procedure will help determine what stage the cancer is and whether it is in the bone marrow. Abnormal findings are often attributed to infection, cancer, or other bone marrow disorders. More tests may be required to confirm a diagnosis.
Direct assessment of bone marrow is important in determining certain blood diseases, and a biopsy is a helpful tool is one of the most accurate tests there is. The pain is minimal in most cases, and many patients report that the procedure wasn’t nearly as bad as they imagined. Find an experienced provider and discuss your condition with your doctor.