Bone marrow biopsy explained: Process, pain management and results

A bone marrow biopsy is a procedure that helps diagnose diseases and other conditions in the blood and bone marrow. MD Anderson performs about 10,000 of these procedures each year.

Here, I’ll address common questions about bone marrow biopsies.

What is bone marrow?

Bone marrow is the soft, spongy tissue located inside your bones. Red blood cells, white blood cells and platelets all come from bone marrow.

Why would a doctor order a bone marrow biopsy?

Your doctor might order a bone marrow biopsy

• if you have an abnormal blood count,
• to help diagnose medical conditions, such as anemia, leukemia and other cancers,
• to see if the cancer has spread to the bone marrow and/or
• to determine if treatment is working.

How is a bone marrow biopsy different from a bone marrow aspiration?

A bone marrow biopsy and a bone marrow aspiration both sample bone marrow to help diagnose disease.

A bone marrow biopsy samples a solid piece of the bone marrow. A bone marrow aspiration takes a sample of the fluid part of your bone marrow.

We usually perform both procedures on a patient because we want to get as much information as possible to make a correct diagnosis.

What types of cancer can a bone marrow biopsy help diagnose?

We perform bone marrow biopsies to help diagnose blood cancers like leukemia, lymphoma and multiple myeloma.

Bone marrow biopsies can also help us determine the cancer’s stage. We can see if the cancer has spread to the bone marrow, particularly in prostate cancer or breast cancer.

What can I expect during a bone marrow biopsy?

You don’t need to do any preparation before a bone marrow biopsy.

The procedure

A bone marrow biopsy is an outpatient procedure. You don’t have to stay overnight in the hospital afterward.

Usually, we’ll biopsy the pelvic bone. First, your provider will numb the area with a local anesthetic. You may feel a prick as they inject the anesthetic, which goes through the skin and down to the bone. Then they’ll insert a special needle through the skin. A small syringe attached to the needle sucks out liquid from your bone marrow. This is a bone marrow aspiration. Then, your provider will insert a small hollow needle to remove a piece of solid tissue from your bone marrow. This is a bone marrow biopsy.

After the samples are collected, your provider will apply pressure to the area to stop bleeding and cover the wound with a bandage.

The entire procedure takes about 20 minutes.

Managing pain

If you are anxious or extremely sensitive to pain, you may be given short-term anesthesia through an IV. This will put you to sleep during the procedure. After the biopsy is completed, you will go to a room to recover. You will need someone to drive you home.

A bone marrow biopsy is not completely painless, but we can control the pain by using local anesthetic or, if necessary, short-term anesthesia. You may experience some discomfort at the biopsy site after the procedure, but it’s very tolerable.

Recovery after the procedure

You should not shower or bathe for a couple of days after your bone marrow biopsy. We want to protect the wound from getting wet, so it doesn’t get infected.

You can resume all normal activities that day. Your provider will give you additional instructions for aftercare. Be sure to follow their advice as you recover.  

Getting your results

A pathologist will analyze your bone marrow samples and share the findings with your provider. Then, your provider will go over the results with you and discuss the next steps.

Michael Andreeff, M.D., Ph.D., specializes in treating leukemia and is medical director of the Bone Marrow Aspiration Clinic at MD Anderson. 

Request an appointment at MD Anderson online or call 1-877-632-6789.