Can Normal Blood Tests Rule Out Blood Cancer? Sternum Pain

Q: Can Normal Blood Tests Rule Out Blood Cancer? Sternum Pain

Hello： Generally, a bone marrow biopsy is performed to diagnose blood cancer only after abnormal results are found in blood tests. <br>You asked if it is possible to have blood cancer despite normal blood test results. <br>In my 15 years as a physician, with 7 years specializing

Midsternal tenderness

Hello, doctor.
Two weeks ago, I went to the hospital for a blood test because I had many small red spots on my arm, suspecting a coagulation issue.
The report showed everything was normal, with normal blood cell counts and types of white blood cells.
However, last night I suddenly noticed a slight pain when pressing down on the center of my sternum.
I would like to know if it is possible to have normal blood test results but still have blood cancer? Thank you!

C, 20~29 year old female. Ask Date: 2018/08/26

Dr. Chen Yunfang reply Oncology

Hello: Generally, a bone marrow biopsy is performed to diagnose blood cancer only after abnormal results are found in blood tests.
You asked if it is possible to have blood cancer despite normal blood test results.
In my 15 years as a physician, with 7 years specializing in hematology, I have never seen or heard of such a case.
Perhaps there is a possibility, but it is likely as rare as winning the lottery! Thank you for your question.

Reply Date: 2018/08/26

More Info

When it comes to the question of whether normal blood tests can rule out blood cancer, particularly in the context of experiencing sternum pain, it is essential to understand the nuances of blood cancer diagnosis and the significance of blood test results.

Blood cancers, such as leukemia and lymphoma, often present with specific symptoms and laboratory findings. Common symptoms may include unexplained bruising, fatigue, fever, night sweats, and weight loss. In your case, you mentioned having a blood test that showed normal results for blood cell counts and types, which is a positive indicator. Generally, a normal complete blood count (CBC) suggests that there are no significant abnormalities in the blood that would typically be associated with blood cancers.

However, it is crucial to note that while normal blood tests significantly reduce the likelihood of blood cancer, they do not entirely rule it out. Blood cancers can sometimes present with normal blood counts, especially in the early stages or in certain types of leukemia. For example, chronic lymphocytic leukemia (CLL) may not always show abnormal blood counts in its initial phases. Additionally, some hematological malignancies may require more specialized tests, such as bone marrow biopsies or flow cytometry, to confirm or rule out the disease.

Regarding your specific concern about sternum pain, it is important to consider that sternum pain can arise from various non-cancerous conditions, including musculoskeletal issues, costochondritis (inflammation of the cartilage connecting the ribs to the sternum), or even gastrointestinal problems like acid reflux. The pain you are experiencing, especially if it is mild and localized, may not be indicative of blood cancer. However, if the pain persists or worsens, it would be prudent to consult a healthcare professional for further evaluation.

In summary, while normal blood tests are reassuring and significantly lower the suspicion of blood cancer, they do not completely eliminate the possibility. If you have ongoing concerns about your health, particularly with new symptoms like sternum pain, it is advisable to follow up with your healthcare provider. They may recommend further investigations or refer you to a specialist if necessary. Remember, early detection and intervention are key in managing any health concerns effectively.

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