Bone Biopsy

What is a bone biopsy?

A biopsy is a test where a piece of tissue is removed from your body. The tissue is then tested to see if there are cancer cells or other issues in the area where the biopsy was done.

A bone biopsy may be done to check for cancer cells in your bone. Cancer cells can start in your bone (called primary bone cancer), or they can spread (metastasize) to your bone from another cancer site in your body. Your bone may also need to be tested for infection, to see why you are having pain, or to test something seen on X-ray.

Cancer can spread to any bone in your body, but tends to spread to bones in the middle of the body, like the spine. Other common sites for bone metastasis are the pelvis (hip), upper leg bone (femur), upper arm bone (humerus), ribs, and the skull. The most common cancers to metastasize to the bone are breast, prostate, lung, thyroid, and kidney cancer.

What are the types of bone biopsy and how are they done?

There are 2 types of bone biopsy:

• Needle biopsy: You may be given medication through an IV to make you sleepy. Numbing medication may be used where the biopsy will be done. A small incision (cut) is made. A long needle is used to remove a piece of tissue from one of your bones. Your provider may use imaging, like a CT, MRI, or ultrasound to help guide the biopsy needle.
• Open biopsy: An open biopsy is surgery to remove part of your bone. You will be given medication through an IV to make you sleep and to not remember the procedure. A large incision is made, and special tools are used to remove a piece of your bone.

Talk to your provider about the type of biopsy you need to have. They will be able to tell you what kind of care you will need after the biopsy, including how to care for your incision and if you will need to change your activity level. They will also be able to tell you if you need to have someone drive you home or if you will need to stay overnight in the hospital.

How can I prepare for a bone biopsy?

Your provider will talk to you about how to prepare for your biopsy. Tell your provider about all medications, herbs, and supplements you take. If you are on blood thinners or take aspirin, your provider may have you stop taking them for a few days before the test. If you have a weakened immune system, you may need antibiotics before the biopsy to prevent infection.

What are the risks of a bone biopsy?

There are some risks of having a bone biopsy. You may have:

• Pain or discomfort at the biopsy site.
• Bruising, swelling, or a small amount of bleeding at the site of the biopsy.
• A pocket of blood (called a hematoma) that collects at the site of the biopsy. This can be uncomfortable but should get better over the next few days. If there is severe pain, call your provider right away.

Serious risks are very rare. If you have any of these, call your provider right away:

• Chills, fever (100.4°F or 38.0°C), or drainage from the biopsy site. This could be an infection of the bone or nearby area.
• New or worsening numbness or tingling near the biopsy site. This could mean that there is nerve damage.
• Severe pain or if you are unable to bear weight on the affected area. There could be a break in the bone (fracture).

How will I get the results of my bone biopsy?

The tissue sample that is removed during the biopsy is looked at under a microscope. This is done by a doctor called a pathologist who writes a pathology report. The report will give your provider information about what was found. Your provider will talk about your results with you.

When should I call my provider?

After your biopsy, your care team will tell you about what to expect. Call your provider’s office if you have:

• Severe pain.
• Bleeding.
• Signs of infection (chills, fever [100.4°F or 38.0°C], or drainage).
• New or worsening numbness and/or tingling.
• Questions about the results of your biopsy.