We tend to take bone marrow biopsies from the back of the pelvis bone. This is where we can access the large bone of the iliac crest with safety. It is rare, but we may need to do the biopsy from the front (anterior iliac crest), or even the sternum (breastbone).
Preparing for your procedure
- A nurse will call you one day before the procedure to provide instruction and to confirm if you are able to attend
- If you missed or unable to get a call from us, we recommend that you fast from midnight on the day before your procedure. You can drink water two hours before your procedure. If you know you will not be receiving sedation of any kind or do not have any other appointments on the same day that requires fasting, you may eat as normal
- Inform the staff if you are diabetic or taking any insulin injections
- Inform the staff if you are taking anticoagulant drugs (“blood thinners”). These can include warfarin, Clexane, clopidogrel or other anticoagulants
- Arrange for someone to help you get home and stay with you overnight after the procedure. You must not drive, sign any pertinent document or work machinery for the rest of the day after any type of sedation
- We recommend you wear loose-fitting comfortable clothing
On the day
- Remember not to eat, but you can drink water two hours before your procedure
- Remember to take your medications for pain, heart and high blood pressure
- Please bring all your medications and any letters or pathology request slips. Your doctor or nurse may have given you these for this procedure
Where to go for biopsies
- Travel to the Melbourne campus
- Go to the admissions desk/front inquiry desk on the ground floor so the staff can admit you to the system and provide wristband and label stickers. Please let the staff know should you need help with the directions
- Go to the main lifts. Press Floor 5 and check which lift you are assigned to
- Ascend to Floor 5
- Go to Reception 5B
Premedication for biopsies
We use local anaesthesia for all our biopsies patients. This gives good pain cover, and you will find that you might not need any other sedation or analgesia.
The biopsies team will discuss with you and help your choice about a premedication. This may be with either an inhaler or an intravenous injection:
- Inhaled sedation, such as methoxyflurane or Penthrox. This is also known as the ‘green whistle’ and is an inhaled light acting pain relief
- Intravenous sedation (midazolam) - supplies quicker and deeper sedation/drowsiness. An opioid called Fentanyl is also administered for pain. We administer this through a cannula we insert in the vein
- Oral sedation (diazepam or lorazepam) is a light sedation that we sometimes give to reduce anxiety and discomfort
During biopsies
You will lie on your side. We will give you local anaesthesia to numb a small area of the skin and on top of your pelvis bone. We make a very small cut on the skin (less than 0.5cm). We insert a needle through the cut and withdraw a liquid sample (aspirate). We use this to make slides and perform other molecular and immunological tests. We then remove a core of tissue (trephine) the size of a matchstick. The procedure is quick, but at times can be uncomfortable. Most patients find the discomfort mild and tolerable.
We ask all patients undergoing bone marrow biopsies to take part in our Tumour Bank Program. We may take more samples of blood and bone marrow at the same time as the procedure. We either use them fresh or store them as a potential resource for future research. We may ask you to sign a separate consent form for participation in this program. Participation in the program is voluntary and you can opt out anytime.
After biopsies
You need to stay under the care of the nursing staff until we discharge you. If we give you an intravenous sedation, you must stay for up to one hour before we discharge you.
After 24 hours you can remove the small waterproof dressing on the biopsy site. You can then apply a clean dressing. We will give you spare dressing and instructions on the day of your procedure.
Side effects and possible complications of biopsies
Bruising and discomfort over the area are common for up to one week after biopsies. Bleeding or infection at the biopsy site are rare complications. Please notify your doctor if the site becomes red, hot or if bleeding persists.
Amnesia (no memory) of the procedure this is common with intravenous sedation. The sedation will not affect your normal memory once it has worn off.
Please do not drive, sign pertinent documents, work machinery or consume alcohol for the rest of the day.
Contact the Cancer Imaging Day Centre if you have any issues after the procedure. Call us on (03) 8559 6582 during work hours. You can also call your treating doctor or the haematology registrar after hours via our switch board on (03) 8559 5000.
Getting your results
We will send the results to your doctor in two to seven days.
Referral information
Your GP or specialist will organise relevant referrals for a Bone marrow biopsy.
Location
Cancer Imaging Day Centre
Level 5, reception 5B Imaging
Peter MacCallum Cancer Centre
305 Grattan Street
Melbourne, 3000
Contact
Imaging
- Phone: (03) 8559 5510
- Fax: (03) 8559 5519