Microscopic examination of a piece of bone and bone marrow. The procedure can be performed in a doctor’s office, using a local anesthetic. A hollow needle is guided into the back area of the pelvic bones or the breastbone (sternum); a core sample of bone with marrow inside is removed. Bone marrow biopsy is used to diagnose blood or bone marrow cancers, such as leukemia or multiple myeloma, or to determine if a malignant tumor from another organ of the body has spread to the bone marrow. It is also used to check for infections, to follow up on the effectiveness of treatment, or to find out how well the bone marrow would produce new blood cells if aggressive chemotherapy were to be used.