Therapeutic Challenges in Managing Triple-Negative Breast Cancer in a Patient With Central Core Disease

Central core disease (CCD) is a congenital myopathy characterized by muscle weakness, skeletal deformities, delayed motor milestones, and susceptibility to malignant hyperthermia. Symptoms of CCD can be exacerbated by various physiological and pharmacological triggers, necessitating careful monitoring, particularly during medical interventions. Breast cancer treatment typically involves modalities such as surgery, radiation, chemotherapy, immunotherapy, and endocrine therapy, all of which may exacerbate underlying myopathic conditions. Chemotherapy and immunotherapy especially have the potential of causing myopathy, myositis, or rhabdomyolysis. Therefore, patients with CCD undergoing breast cancer treatment require vigilant surveillance to mitigate the risks associated with disease exacerbation. We report the case of a 41-year-old female patient with coexisting CCD and breast cancer who underwent neoadjuvant chemotherapy and immunotherapy, followed by surgical intervention and radiation therapy. Given her underlying myopathy, she was at an elevated risk for treatment-related complications, requiring regular monitoring of serum creatine kinase, myoglobin, and aldolase levels throughout her treatment course. The patient completed treatment without exacerbation of her myopathy and is currently in remission after two cycles of maintenance immunotherapy. For her surgery, surgeons were cautioned to take all necessary precautions to prevent malignant hyperthermia by avoiding certain anesthetics. This case highlights the importance of early intervention, close monitoring, and multidisciplinary management in patients with concurrent CCD and breast cancer.