Bone marrow biopsy and aspiration

This page was reviewed under our medical and editorial policy by

Maurie Markman, MD, President, Medicine & Science

This page was updated on May 2, 2022.

When the care team wants to evaluate whether a patient's bone marrow is healthy and appropriately producing blood cells, they may recommend a bone marrow biopsy or aspiration. Since these procedures are typically performed during the same session, the care team may refer to them as a bone marrow exam.

Bone marrow biopsy vs. aspiration procedure

While a bone marrow biopsy involves extracting the solid portion of bone marrow, the aspiration involves extracting the fluid portion.

During the aspiration, which typically takes place first, a needle is used to collect a sample of the liquid portion of bone marrow—the spongy tissue inside large bones—so it may be tested. The needle enters through the skin and goes through muscle and the outer edge of the bone to reach the marrow. The extracted fluid is then examined by a pathologist.

During the biopsy, the care team uses a bigger needle, which allows them to take a small piece of bone along with the cells and tissue. This sample is examined by a pathologist as well.

The aspiration and biopsy procedures may help the care team determine how well certain types of blood cancer treatments—such as for leukemia, lymphoma or multiple myeloma—are working. The bone marrow aspiration and biopsy may also help determine whether cancer has grown or spread, as discussed in more detail below.

Before the biopsy

Find the right facility: A bone marrow biopsy may be performed at a specialist’s office or at a hospital. Speak with the care team about which venue may be most comfortable.

Keep medical records organized: The technologist may ask for personal and medical histories, including past surgeries and a list of current medications.

Discuss any personal risk factors: Alert the care team if the patient is pregnant or has any medication allergies or bleeding problems.

Review instructions for food and drink: Preparation is based on the doctor’s orders, so ask about food and drink intake ahead of the procedure.

Dress accordingly: Since patients are often asked to disrobe for the procedure, it may be more convenient to wear loose clothing that’s easy to remove. The facility typically provides a wrap or gown for convenience.

Manage anxiety: Consider speaking with the care team about ways to manage any anticipated anxiety, such as by taking an anti-anxiety medication.

Allot enough time: The entire procedure typically takes less than 30 minutes, but the process may take longer, including preparing for the procedure and possibly resting afterward.

During the biopsy

Get as comfortable as possible: Patients are often asked to lie on the procedure table on their side or stomach, depending on the biopsy site.

Be ready for slight discomfort A local anesthetic is administered to numb the tissue around the bone. After a slight stinging sensation, the area goes numb. When the large needle is inserted into the biopsy site to withdraw the bone marrow sample, it may cause a dull, aching pain for a few moments.

Don’t be afraid to speak up: It’s not uncommon to feel anxious or a little scared during a bone marrow biopsy, so speak up if it's too uncomfortable or the patient needs more anesthetic.

Lean on a friend or family member: Consider bringing someone for support, comfort or company. Check with the facility to see whether there are any restrictions.

After the biopsy

Take care of the area: Leave the bandage in place and keep the biopsy area as clean and dry as possible for as long as the care team recommends.

Know the pain relief options: Pain may be managed with an over-the-counter pain reliever, as recommended by the doctor.

Know when to expect biopsy results: Biopsy results are typically processed and shared within two to three days after the procedure, but a more thorough analysis may take between seven to 10 days. Plan to receive a full explanation of results from the care team. 


Possible risks

The patient may experience some achiness or mild discomfort for a week after the biopsy, as well as some bleeding or bruising at the puncture site. Serious bleeding or infection is rare. If the patient has any concerns, it's a good idea to speak directly with the care team.

Common questions about bone marrow biopsy

Can the patient be sedated for a bone marrow biopsy?

Some patients may be anxious about the bone marrow aspiration and biopsy procedure, and in these cases, the provider may provide partial or complete sedation during the aspiration. This allows the patient to rest more comfortably during the procedure.

How painful is a bone marrow biopsy?

The patient will likely feel a sharp stinging sensation during the bone marrow aspiration, but one study found that most patients described the pain as bearable and moderate. Patients who are concerned about pain should talk to the care team about anesthesia options.

How long does a bone marrow biopsy take?

The actual bone marrow aspiration and biopsy typically take about 30 minutes, which includes a short period following the aspiration when the patient will need to apply pressure to the area where the needle was inserted. After leaving the procedure room, patients who received local anesthesia may be able to resume their normal activities. For patients who had intravenous sedation, however, recovery may take longer. The patient will need a ride home and should avoid any strenuous activities for about 24 hours.

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