A bone biopsy is a procedure in which a sample of bone tissue is taken, usually with the help of a needle, to be examined in a laboratory to differentiate bone tumors from other health issues, confirm the diagnosis of a detected disorder in the bone, or investigate the cause of pain in the bone. Bone biopsy, which plays an important role among the diagnostic methods for bone diseases, is usually performed when lesions suspected of cancer are detected during advanced imaging methods.
What is a Bone Biopsy and When is it Applied?
A bone biopsy is a procedure in which an interventional radiologist takes a tissue sample from the bone using a biopsy needle or surgical methods to investigate the presence of abnormal cells, such as cancer cells, in the bone, and then examines the obtained tissue sample under a microscope. Unlike a bone marrow biopsy, during a bone biopsy, the tissue sample is taken from the outer part of the bone rather than the inner part. Although bone biopsy forms the basis for the diagnosis and treatment of bone tumors, it is not performed for every case of bone pain or bone disease. The situations where a bone biopsy may be indicated are as follows:
- To confirm the diagnosis of a disorder detected in the bone through imaging methods,
- To investigate an abnormal area or lesion seen in advanced imaging methods such as PET CT, Computed Tomography, or Magnetic Resonance Imaging,
- To differentiate a bone tumor from other bone diseases such as bone infection,
- To investigate whether a mass in the bone is benign or malignant,
- To determine the cause of an infection or inflammation and to plan treatment in advance.
In addition to the above, a biopsy may also be performed in cases of unexplained bone pain where the cause cannot be determined by other diagnostic methods for bone diseases.
How is a Bone Biopsy Performed and What are the Types of the Procedure?
The bone biopsy procedure involves taking a small sample of bone tissue and examining it under a microscope. During a bone biopsy, specialists can perform the procedure in two different ways depending on the size of the tissue sample needed for diagnosis. Accordingly, the main types of bone biopsy are as follows:
- Needle Biopsy: During the bone biopsy procedure, after local anesthesia is applied to the procedure area, a small incision is made, and a sample of bone tissue is taken using a special biopsy needle. During the procedure, specialists usually utilize an imaging technique such as X-ray or computed tomography to ensure that the needle is in the correct position. As a minimally invasive method, most patients can return to their normal lives shortly after a needle biopsy.
- Open Biopsy: Also known as surgical bone biopsy, open biopsy is generally preferred when the result of the needle biopsy is negative but the specialists still have doubts or when a larger sample of bone tissue is needed for diagnosis. Open biopsy, which is usually performed with the assistance of general anesthesia, involves the specialist surgeon making a larger incision to take a sample from the bone tissue.
Bone biopsy plays an important role in the diagnosis and treatment of bone diseases. Bone marrow biopsy, which is often confused with bone biopsy, is a method used for diagnosing blood diseases such as anemia, lymphoma, and leukemia.
What is the Patient Preparation Process Before a Bone Biopsy?
The preparation for a bone biopsy is crucial for the smooth execution of the procedure and for reducing the risk of complications. During this process, specialists first provide detailed information to the patient about the procedure and request the patient to sign a written consent form. It is important for patients to share the medications, vitamins, or herbal supplements they are taking with their doctors. Especially some medications that have blood-thinning properties may increase the risk of bleeding, so these medications may need to be discontinued under medical supervision a few days before the procedure. Additionally, it is important for the patient to inform their doctor about any known allergies to medications.
In cases where the procedure needs to be performed under general anesthesia, patients are advised to refrain from eating and drinking for at least 6-8 hours before the procedure. In some cases, patients may be allowed to consume clear liquids up to 2 hours before the procedure. Blood tests may be performed to check the patient’s blood values, and tests such as EKG may be conducted to assess heart health. Furthermore, if general anesthesia or sedation is to be applied, the patient may need to come with an escort on the day of the procedure.
What Risks and Complications Can Be Seen During and After a Bone Biopsy?
When performed in a sterile environment by expert physicians, a bone biopsy is generally a safe procedure; however, some risks and complications may rarely develop. The first risk that comes to mind when mentioning the risks of bone biopsy is infection at the procedure site. Like any procedure performed on the skin, a bone biopsy, especially when performed using the open biopsy method, may carry a risk of infection. To minimize this risk, specialists may prescribe antibiotic medications after the procedure in some cases. Persistent redness, swelling, discharge, or high fever at the procedure site may indicate the presence of infection, so it is important to inform the performing doctor without delay if any of these complications occur.
After a bone biopsy, bleeding may occur, especially in patients who were taking blood-thinning medications before the procedure. A small amount of bleeding after the procedure is normal. However, if the bleeding continues for a long time or is severe, it is important to consult a doctor. Additionally, complications such as pain and redness after a bone biopsy are common. Specialists may prescribe pain relief medications after the procedure to manage pain. Furthermore, the risk of bone fracture may increase after a bone biopsy. The main reason for this is that the biopsy procedure creates a weak point in the bone. To prevent the risk of bone fracture, specialists may recommend patients to use crutches for a while in cases where they took a sample from the leg bone to reduce the load on the leg.
How Long Does it Take for Bone Biopsy Results to Come Out and How are They Evaluated?
Bone biopsy results are generally ready within one to two days after the procedure. The time it takes for the biopsy report to be ready may vary depending on the biopsy technique or the purpose of the biopsy. For example, in cancer evaluation, special staining techniques and genetic analyses may be required, which can prolong the preparation time of the report. The biopsy result provides information on whether the tissue contains a benign or malignant mass, and whether there are signs of infection or inflammation. Based on the results, doctors may recommend additional tests or start treatment aimed at diagnosis.
Frequently Asked Questions
Why is a Bone Biopsy Performed?
A bone biopsy is usually performed to diagnose a bone abnormality, determine the cause of a bone infection, identify the source of pain, or investigate whether a mass in the bone is benign or malignant.
What Should Be Done After a Bone Biopsy?
After the procedure, most patients can return home on the same day. Since complications such as pain may occur after a bone biopsy, specialists may prescribe pain relief medications. Additionally, to minimize the risk of infection, antibiotic medications may be recommended. It is important to use these medications as prescribed by doctors. It is also advised to avoid physical activity for at least 24 hours and to take care not to wet the procedure site.
How is a Bone Biopsy Performed?
If formations such as cysts are detected in the bone through imaging methods, a bone cyst biopsy can be performed by taking a tissue sample from the bone using a needle or open surgical method.
Is Bone Marrow Biopsy Risky?
Although the risk of the procedure is low, complications similar to those seen after other medical procedures, such as pain, bleeding, and infection, may occur. Especially in individuals with low platelet counts, excessive bleeding may develop. If bleeding continues for a long time, it is important to inform specialists without delay.
What Does Taking a Piece from the Bone Mean?
The procedure commonly referred to as taking a piece from the bone is a biopsy procedure in which a tissue sample is taken from the bone for examination in cases where various health issues are suspected.
What Happens if a Bone Cyst is Not Removed?
Bone cysts, which are fluid-filled sacs commonly seen in children and adolescents, usually do not indicate a dangerous health problem. Small cysts may be adequately monitored with routine check-ups. However, if the cyst continues to grow and causes disruption in the bone, it may need to be drained using aspiration, meaning it is emptied with a needle. In some cases, the cyst may be surgically removed from the bone and the empty space may be filled with bone grafting using bone taken from another part of the body.
