A Potential Role of Chronic Exposure to Extremely Low-Frequency Electromagnetic Fields in Triggering Persistent Pain Post Breast Cancer Surgery: A Review

Abstract

Persistent Pain after Breast Cancer Surgery (PPBCS) ranks second to amputation of extremities for neuropathic chronic pain. PPBCS is associated with the formation of intercostobrachial neuroma bulbs along the lateral chest. These neuroma bulbs are either un-/thinly myelinated and express hypersensitivity to environmental stimuli. Hypersensitivity is manifested as spontaneous pain in response to innocuous stimuli and exaggerating pain in response to noxious stimuli. Excision of neuromas, a common intervention to alleviate pain, has been reported as ineffective. Experience of individuals with amputation of extremities and experimental models of human nerve injuries confirm anthropogenic EMF evoke excruciating pain. Findings from invitro and animal studies clearly support that EMF exposure depolarizes cell membranes, interrupts voltage gated calcium channels which then activates peripheral sensory neurons and initiates propagation of a train of action potentials along the axons of primary afferent nerve fibers. The World Health Organization guidelines, established based on approximation of the human anatomy are limited and assumes no potential compounding effects of nerve injuries or alterations of physiological milieu of tissues. The objective of this review is to direct the attention of the medical community to the potential role of anthropogenic EMF as a risk factor for persistent pain after breast surgery. Patients rely heavily on the recommendations of their providers to manage their pain. The current epidemic of opioid abuse in the US has been partially attributed to the high prescription rate of opioid-based pain killers. Understanding the potential triggers of chronic pain can reduce dependency on pharmaceutical agents.