What is Bone Marrow Biopsy? Purpose, Procedure & Results

A bone marrow biopsy is a medical procedure where your doctor removes a small sample of bone marrow tissue to examine under a microscope. This tissue lives inside your bones and produces all your blood cells, including red blood cells, white blood cells, and platelets. Think of it as getting a close look at your body's blood cell factory to understand how well it's working.

What is bone marrow biopsy?

Bone marrow biopsy involves taking a tiny piece of the spongy tissue inside your bones, usually from your hip bone. Your bone marrow is like a busy factory that constantly makes new blood cells to replace old ones throughout your body. When doctors need to understand why your blood counts might be abnormal or diagnose certain conditions, they examine this tissue directly.

The procedure typically takes about 30 minutes and is done as an outpatient visit. You'll lie on your side while your doctor uses a special needle to extract a small sample from the back of your pelvic bone. Most people describe the discomfort as brief but intense pressure, similar to getting a vaccination but lasting a few seconds longer.

Why is bone marrow biopsy done?

Your doctor might recommend a bone marrow biopsy when blood tests show unusual results that need further investigation. The most common reason is to help diagnose blood disorders, cancers affecting blood cells, or to monitor how well certain treatments are working.

Here are the main reasons doctors perform this test, and knowing why can help you feel more prepared:

• Diagnosing blood cancers like leukemia, lymphoma, or multiple myeloma
• Investigating unexplained anemia or low blood cell counts
• Checking for infections that might affect bone marrow
• Monitoring treatment progress for blood disorders
• Evaluating whether cancer has spread to the bone marrow
• Diagnosing rare bone marrow disorders like myelofibrosis

Sometimes doctors also use this test to investigate fever of unknown origin or unusual bleeding patterns. The biopsy gives them detailed information that blood tests alone cannot provide.

What is the procedure for bone marrow biopsy?

The bone marrow biopsy procedure happens in your doctor's office or outpatient clinic, and you'll be able to go home the same day. Your healthcare team will guide you through each step to ensure you feel comfortable and informed throughout the process.

Here's what you can expect during the procedure, step by step:

1. You'll lie on your side or stomach on an examination table
2. Your doctor will clean the skin over your hip bone with antiseptic
3. Local anesthetic is injected to numb the area completely
4. A hollow needle is inserted through your skin into the bone
5. Bone marrow liquid is drawn out first (aspiration)
6. A small piece of bone with marrow is removed (biopsy)
7. Pressure is applied to stop any bleeding
8. A bandage is placed over the site

The actual sampling takes only a few minutes, though you might feel pressure when the needle enters the bone. Most people find the anticipation more uncomfortable than the procedure itself.

How to prepare for your bone marrow biopsy?

Preparing for your bone marrow biopsy is straightforward, and your healthcare team will give you specific instructions based on your medical history. The goal is to make sure you're as comfortable as possible and that the procedure goes smoothly.

Your doctor will likely ask you to make these preparations in the days leading up to your biopsy:

• Stop taking blood-thinning medications like aspirin or warfarin if instructed
• Inform your doctor about all medications and supplements you take
• Eat a light meal before the procedure unless told otherwise
• Arrange for someone to drive you home afterward
• Wear comfortable, loose-fitting clothing
• Bring a list of your current medications

You don't need to fast unless your doctor specifically asks you to. Some people find it helpful to bring headphones or ask if they can listen to music during the procedure to help them relax.

How to read your bone marrow biopsy results?

Your bone marrow biopsy results will come back in about one to two weeks, as the tissue needs time to be processed and examined carefully by a pathologist. The report will include detailed information about your bone marrow's structure, cell types, and any abnormal findings.

Normal results typically show healthy bone marrow with the right mix of developing blood cells. Your doctor will explain what the findings mean for your specific situation, but generally, normal results indicate that your bone marrow is producing blood cells properly and shows no signs of cancer or other serious conditions.

Abnormal results might reveal several different conditions, and your doctor will walk you through what they've found:

• Too few or too many of certain cell types
• Presence of abnormal or cancerous cells
• Signs of infection or inflammation
• Scarring or fibrosis in the bone marrow
• Evidence of genetic abnormalities in cells
• Infiltration by cancer cells from other parts of the body

Remember that abnormal results don't always mean something serious. Sometimes they simply confirm what your doctor already suspected and help guide the right treatment plan for you.

What are the risk factors for abnormal bone marrow biopsy results?

Several factors can increase your likelihood of having abnormal bone marrow biopsy results, though having these risk factors doesn't guarantee you'll develop problems. Understanding these can help you and your doctor make informed decisions about your health.

Age is one of the most significant factors, as bone marrow function naturally changes over time. People over 60 are more likely to develop blood disorders, though these conditions can occur at any age. Family history also plays a role, especially for certain genetic blood disorders.

Other risk factors that might affect your bone marrow health include:

• Previous chemotherapy or radiation treatment
• Exposure to certain chemicals like benzene
• Smoking tobacco products
• Certain genetic conditions
• Autoimmune disorders
• Chronic infections
• Some medications taken long-term

Environmental factors and lifestyle choices can also influence bone marrow health, though many people with risk factors never develop problems. Your doctor considers all these factors when interpreting your results.

What are the possible complications of bone marrow biopsy?

Bone marrow biopsy is generally very safe, but like any medical procedure, it carries some small risks. Serious complications are rare, occurring in less than 1% of procedures, but knowing what to watch for can help you feel more prepared.

The most common side effects are mild and temporary, including soreness at the biopsy site for a few days. You might also notice some bruising or slight bleeding where the needle was inserted, which is completely normal and should resolve within a week.

Here are the potential complications to be aware of, though most are uncommon:

• Infection at the biopsy site
• Excessive bleeding
• Prolonged pain or discomfort
• Allergic reaction to local anesthetic
• Damage to nearby structures (extremely rare)
• Fainting during or after the procedure

Your healthcare team will monitor you after the procedure and give you clear instructions about caring for the biopsy site. Most people return to normal activities within a day or two.

When should I see a doctor after bone marrow biopsy?

You should contact your doctor if you experience any concerning symptoms after your bone marrow biopsy. While most people recover without problems, it's important to know when to seek medical attention.

Call your doctor right away if you develop signs of infection or other complications:

• Fever over 101°F (38.3°C)
• Increasing pain that doesn't improve with over-the-counter pain medication
• Excessive bleeding or drainage from the biopsy site
• Redness, warmth, or swelling around the area
• Pus or foul-smelling discharge
• Persistent nausea or vomiting

You should also reach out if you have questions about your results or need clarification about your treatment plan. Your healthcare team wants you to feel informed and comfortable throughout this process.