Conhecimentos e dificuldades das mães face à amamentação

Enquadramento: Devido à elevada prevalência de abandono precoce da amamentação, diversas instituições (e.g., OMS, UNICEF) têm-se preocupado em proteger, promover e apoiar o aleitamento materno um pouco por todo o mundo, defendendo a sua exclusividade durante os primeiros seis meses de vida do bebé, complementado a partir dessa idade pela introdução de alimentos e mantido até aos 2 anos de idade ou mais, se esse for o desejo da mãe. Objetivos: Avaliar os conhecimentos das mães sobre a amamentação; identificar as dificuldades vivenciadas pelas mães em relação à amamentação; analisar a relação entre as variáveis sociodemográficas e obstétricas das mães e os seus conhecimentos e dificuldades sobre a amamentação. Metodologia: Estudo quantitativo, descritivo, analítico, correlacional e de corte transversal, conduzido numa amostra não probabilística de 100 mães de recém-nascidos e/ou lactentes até 1 ano de vida, internadas no serviço de obstetrícia, neonatologia, pediatria e urgência de uma Unidade Local de Saúde do Norte do País. As inquiridas tinham idade mínima de 16 e máxima de 43 anos (M=30,77; Dp=6,356). Foi utilizado um questionário de caraterização sociodemográfica e um questionário de autorrelato da vivência das mães sobre a amamentação, desenvolvido por Sousa (2014). Resultados: Os principais resultados mostraram que 50% das mães consideram possuir bons conhecimentos relativos à amamentação, porém, apenas 39% foram classificadas com bons conhecimentos, enquanto 52% revelaram dificuldades elevadas. Os conhecimentos foram avaliados tendo por base a sinalização correta da importância da amamentação na primeira hora de vida do bebé por 93% das mães, exclusiva até aos 6 meses (28%), a composição do leite materno e composição imunológica 93%, a maioria das mães considerou saber identificar os sinais da pega correta. Relativamente ao horário da amamentação, 62% ainda considera correto amamentar de três em três horas e 14% defende que o bebé deve mamar 10 minutos em cada mama. Os conhecimentos relacionaram-se significativamente com as mães com ensino superior (x2=17,828; p=0,00) e nas que se encontram a amamentar atualmente (UMW=278,000; p=0,01). As dificuldades mais prevalentes associaram-se às fissuras (56,4%), ingurgitamento mamário (38,5%), mastite (3,8%), dor (40%) e dificuldade na pega (60%), tendo-se constatado diferenças estatisticamente significativas associadas ao ingurgitamento mamário, à mastite e abcesso mamário. Exerce influência nas dificuldades das mães, ter sido informada pelo obstetra (UMW=324,000; p=0,02) e não ter expectativas na primeira amamentação (UMW=521,500; p=0,01). Conclusão: O estudo revela bons conhecimentos globais mas dificuldades elevadas, sendo estas as comumente referenciadas noutros estudos. Face a isto, mantem-se necessário apoiar nas dificuldades vividas durante a amamentação, adequando as estratégias de promoção, proteção e apoio ao AM, para que os resultados possam ser bem-sucedidos. Palavras-chave: aleitamento materno, conhecimentos, dificuldades.

Dificuldades no aleitamento materno

Enquadramento: Apesar de o leite materno ser globalmente aceite como o alimento mais completo e efetivo para assegurar a saúde do bebé, além dos claros benefícios para a mãe, continua-se a verificar que a taxa de amamentação está ainda longe da pretendida. Objetivos: Identificar a evidência científica dos determinantes da interrupção do aleitamento materno aos 6 meses de vida do bebé. Métodos: Foi realizada uma revisão sistemática da literatura sobre as dificuldades que levam à interrupção do aleitamento materno aos 6 meses de vida do bebé. Efetuou-se uma pesquisa na PUBMED, The Cochrane Library, Scielo e Google Académic de estudos publicados entre janeiro de 2010 a outubro de 2015, partindo dos critérios de inclusão previamente definidos, os estudos selecionados foram posteriormente avaliados. Dois revisores avaliaram a qualidade dos estudos a incluir, utilizando a grelha para a avaliação crítica de um estudo. Após a avaliação crítica da qualidade, foram incluídos no corpus de estudo 4 artigos com scores entre 87.5% e 95.0%. Resultados: Como metasíntese e seleção da análise dos artigos, inferiu-se que os fatores que levam à interrupção do aleitamento materno aos 6 meses de vida do bebé são: as preocupações com a lactação, perda de peso do bebé, doença da mãe ou a necessidade de tomar medicação, bloqueio dos ductos mamários, problemas relacionados com a gestão psicossocial, conflitos no seu estilo de vida, o posicionamento e pega inadequados, queixa de leite insuficiente ou fraco, dor à amamentação, fissuras, ingurgitamento mamário, a ansiedade materna e o choro da criança. Conclusões: Perante a evidência científica, as causas de abandono do aleitamento materno são multifatoriais e estão associadas à mãe, ao bebé e à saúde. A promoção do aleitamento materno exige programas de educação baseados na evidência, contribuindo para melhoria dos índices nacionais de prevalência da amamentação até, pelo menos aos 6 meses de vida do bebé, que se deseja cada vez mais consentânea com as melhores práticas internacionais. Palavras-Chave: Aleitamento materno; Dificuldades; Interrupção.

Avaliação da suplementação materna com megadose de vitamina A sobre os níveis de retinol e alfa-tocoferol no colostro

The vitamins A and E are recognizably important in the initial stages of life and the newborn depends on nutritional adequacy of breast milk to meet their needs. These vitamins share routes of transport to the tissues and antagonistic effects have been observed in animals after supplementation with vitamin A. This study aimed to verify the effect of maternal supplementation with vitamin A megadose (200,000 UI) in the immediate post-partum on the concentration of alpha-tocopherol in colostrum. Healthy parturient women attended at a public maternity natalensis were recruited for the study and divided into two groups: control (n = 37) and supplemented (n = 36). Blood samples of colostrum and milk were collected until 12 hours after delivery. The women of the supplemented group was administered a retynil palmitate capsule and 24 hours after the first collection was obtained the 2nd sample of colostrum in two groups for analysis of retinol and alpha-tocopherol in milk. The mean retinol concentration of 50,7 ± 14,4 μg/dL (Mean ± standard deviation) and alpha-tocopherol of 1217.4 ± 959 mg/dL in the serum indicate the nutritional status biochemical appropriate. Supplementation with retynil palmitate resulted in increase not only retinol levels in the colostrum of the supplemented group (p = 0.002), but also the concentration of alpha-tocopherol (p = 0.04), changing from 1456.6 ± 1095.8 mg/dL to 1804.3 ± 1432.0 mg/dL (milk 0 and 24 respectively) compared to values in the control group, 984.6 ± 750.0 mg/dL and 1175.0 ± 730.8 mg/dL. The women had different responses to supplementation, influenced by baseline levels of retinol in colostrum. Those with previous by low levels of retinol in colostrum (<60 mg/dL) had increased the concentration of alpha-tocopherol in milk, whereas those with adequate levels (> 60 mg/dL), showed a reduction after supplementation. Supplementation with retinol palmitate is an important intervention in situations of high risk for vitamin A deficiency, when considering the need to maternal supplementation, since the excess vitamin can offer unfavorable interactions between nutrients essential for the mother-child group

Efeito da suplementação materna com palmitato de retinila sobre a concentração de retinol no colostro em condições de jejum e pós-prandial.

Vitamin A is important in many essential body processes and its deficiency results in serious consequences for human health. Breast milk is the only source of this vitamin for children that are exclusively breastfed. Analysis of vitamin A in mother s milk is important because its concentration is related to maternal vitamin A status and to its ingestion by the mother during pregnancy. The aim of the present study was to assess the effect of maternal supplementation with retynil palmitate on the concentration of colostrum retinol under fasting and postprandial conditions. A total of 149 nursing mothers were recruited at the Januário Cicco Maternity School (Natal, Brazil) and allocated to two groups: Comparison (n = 69) and Test (n = 80). Blood and colostrum (in fasting and postprandial conditions) samples were collected up to 24hs after delivery. Serum retinol and colostrum levels were analyzed by high-performance liquid chromatography. The serum retinol level of 41.6 ± 12.7μg/dL (mean ± standard deviation) indicates adequate biochemical nutritional status. Colostrum retinol level was not influenced by serum retinol levels under any of the conditions established. In the colostrum, the retinol concentration in the unsupplemented test group was 67.3 ± 37.7 μg/dL under fasting and 80.3 ± 35.1 μg/dL under postprandial conditions (p<0.05), showing an increase of 19.3%. In the supplemented test group the values were 102.6 ± 57.3 μg/dL and 133.4 ± 78.3 μg/dL under fasting and postprandial, respectively (p<0.05), representing an increase of 30%. Considering that under fasting conditions most of the vitamin A transported to the milk originates in the retinol binding protein (RBP), the postprandial increase in colostrum retinol suggests a different transport mechanism of retinol to maternal milk from that performed by RBP. This situation becomes more evident under supplementation conditions.

Efeito do estado nutricional bioquímico de retinol e alfatocoferol sobre seus níveis em lactantes

Vitamins A and E are essential nutrients in many biological processes, so that their adequate supply to the neonate is crucial. However, the bioavailability of vitamins may be limited by factors such as maternal nutritional status and the interaction between nutrients. This study aimed to investigate the effect of biochemical nutritional status of retinol and alpha-tocopherol levels in serum and colostrum. The study included 103 healthy puerperal women treated at the reference state maternity hospital (Natal-RN). Colostrum and serum samples were collected fasting in the immediate postpartum period and the analysis of retinol and alpha-tocopherol were determined by high-performance liquid chromatography. Specific cutoff points were adopted to characterize the biochemical status of vitamins A and E. For the total group of lactanting women the average concentration of retinol in serum (1.49 ± 0.4 μmol/L-1) and colostrum (2.18 ± 0.8 μmol/L-1), as well as alpha-tocopherol in serum (26.4 ± 8.0 μmol/L-1) and colostrum (26.1 ± 12.8 μmol/L-1), indicated adequate biochemical state. However, when evaluating the individual, was found a high prevalence of deficient serum (15%) and colostrum retinol (50%), and also alphatocopherol in serum (16%) and colostrum (61%). In women with serum retinol ≥ 1.05 μmol/L-1, found an inverse correlation between serum retinol and alpha-tocopherol in colostrum (p = 0.008, r = -0.28). This association was not observed in women with serum retinol <1.05 μmol/L-1. This situation demonstrates for the first time in humans that high physiological levels of serum retinol, without supplementation, can negatively influence the transfer of alpha-tocopherol in breast milk. Although the diagnosis of satisfactory nutritional status lactanting women showed high risk of subclinical deficiency of vitamins A and E from measurements made in the colostrum

Avaliação do retinol em parturientes com diabetes mellitus gestacional no pós parto imediato

Micronutrient deficiencies affect individuals mainly in developing countries, where vitamin A deficiency is a public health problem worldwide more worrying, especially in groups with increased physiological needs such as children and women of reproductive age. Vitamin A is supplied to the body through diet and has an important role in the visual process, cell differentiation, maintenance of epithelial tissue, reproductive and resistance to infection. The literature has demonstrated the relationship between vitamin A and diabetes, including gestational, leading to a risk to both mother and child. Gestational diabetes is any decrease in glucose tolerance of variable magnitude diagnosed each the first time during pregnancy, and may or may not persist after delivery. Insulin resistance during pregnancy is associated with placental hormones, as well as excess fat. Studies have shown that retinol transport protein produced in adipose tissue in high concentrations, this would be associated with resistance by interfering with insulin signaling. Therefore, this study aimed to evaluate the concentration of retinol in serum and colostrum from healthy and diabetic mothers in the immediate postpartum period. One hundred and nine parturient women were recruited, representing seventy-three healthy and thirty-six diabetic. Retinol was extracted and subsequently analyzed by High Performance Liquid Chromatography. Among the results highlights the mothers with gestational diabetes were older than mothers healthy, had more children and a higher prevalence of cases of cesarean section. Fetal macrosomia was present in 1.4% of healthy parturient women and in 22.2% of diabetic mothers. The maternal serum retinol showed an average of 39.7 ± 12.5 mg/dL for healthy parturients 35.12 ± 15 mg/dL for diabetic and showed no statistical difference. It was observed that in the group of diabetic had 17% vitamin A deficiency, whereas in the healthy group, only 4% of the women were deficentes. Colostrum, the concentration of retinol in healthy was 131.3 ± 56.2 mg/dL and 125.3 ± 41.9 mg/dL in diabetic did not differ statistically. This concentration of retinol found in colostrum provides approximately 656.5 mg/day for infants born to healthy mothers and 626.5 mg/day for infants of diabetic mothers, based on a daily consumption of 500 mL of breast milk and need Vitamin A 400 mg/day, thus reaching the requirement of the infant. The diabetic mothers showed significant risk factors and complications related to gestational diabetes. Although no 11 difference was found in serum retinol concentration and colostrum among women with and without gestational diabetes, the individual analysis shows that parturients women with diabetes are 4.9 times more likely to develop vitamin A deficiency than healthy parturients. However, the supply of vitamin A to the newborn was not committed in the presence of gestational diabetes

Avaliação da suplementação com vitamina E, na forma natural ou sintética, em mulheres no pós-parto imediato e sua concentração no colostro

The Vitamin E consists of eight chemically homologous forms, designated alpha, beta, gamma and delta tocopherols and tocotrienols. Biologically, the alpha-tocopherol (α-TOH) is the most important. Commercially, are found two types of α-TOH a natural (RRR-alpha-tocopherol) and another synthetic (all-rac-alpha-tocopherol). Both forms are absorbed in the intestine, the liver is a preference in favor of forms 2R, due to transfer protein α-TOH. It has higher affinity to these stereoisomers. Newborns are considered high risk for vitamin E deficiency, mainly premature, these have breast milk as a food source for maintenance of serum α-TOH. Clinical signs such as thrombocytosis, hemolytic anemia, retrolental fibroplasia, intraventricular hemorrhage, bronchopulmonary dysplasia and spinocerebellar degeneration can be found in case of a low intake of α-TOH. Thus, maternal supplementation on postpartum with α-TOH can be an efficient way to increase levels of vitamin E in breast milk and thus the consequently increase the supply of micronutrient for the newborn. However, most studies with vitamin E supplementation have been conducted in animals and little is known about the effect of maternal supplementation in humans, as well as on its efficiency to increase levels of α-TOH in human milk, depending on the shape natural or synthetic. The study included 109 women, divided into three groups: control without supplementation (GC) (n=36), supplemented with natural capsule (GNAT) (n=40) and the synthetic capsule (GSINT) (n=33). Blood samples were collected for determination of maternal nutritional status, and colostrums at initial contact and after 24 hours post-supplementation. Analyses were performed by High Performance Liquid Chromatography. Values of α-TOH in serum below 499.6mg/dL were considered deficient. We used the Kruskal-Wallis test and Tukey test to confirm the increase of alpha-tocopherol in milk and efficiency of administered capsules. Daily consumption of α-TOH was based on daily intake of 500 mL of colostrum by the newborn and compared with the nutritional requirement for children from 0 to 6 months of age, 4 mg / day. The mothers had mean concentration of serum α-TOH in 1016 ± 52, 1236 ± 51 and 1083 ± 61 mg / dL, in CG, GNAT and GSINT respectively. There were no women with deficiiency. The GC did not change the concentrations of α-TOH in colostrum. While women supplemented with natural and synthetic forms increased concentrations of α-TOH colostrum in 57.6% and 39%, respectively. By comparing supplemented groups, it was observed a significant difference (p=0.04), the natural capsule more efficient than the synthetic, approximately 49.6%. Individually, 21.1% of the women provided below 4mg/day of α-TOH, after supplementation for this index declined4.1%. Thus, maternal supplementation postpartum raised the levels of alpha-tocopherol in colostrum, and increased efficiency was observed with the natural form

Efficacy of early skin-to-skin contact on the rate of exclusive breastfeeding in term neonates: a randomized controlled trial

Background: Despite multiple benefits of breast milk, the rates of exclusive breastfeeding in developing countries are low. Objective: To evaluate the efficacy of early skin -to -skin contact (SSC) on the rate of exclusive breastfeeding (EBF) at 6 weeks of age among term neonates born by vaginal delivery. Methods: Term neonates born by vaginal delivery and did not require any resuscitation were randomized at birth to SSC (n=100) and control (n=100) group. Immediately after clamping the umbilical cord, SSC group neonates were placed on the bare bosom of mother and control group neonates were placed under a radiant warmer for a period of 45 minutes each while mothers underwent management of the third stage of labor and episiotomy repair. Pain experienced by mother during episiotomy repair was recorded using a numerical pain scale The primary outcome evaluated was the rate of exclusive breastfeeding at 6 weeks of postnatal age. Results: A significantly higher proportion of neonates were exclusively breastfeed at 6 weeks of age in the SSC group than in the control group (72% vs. 57.6%, p=0.04, relative risk: 1.3, 95% confidence interval: 1.0 -1.6). The pain score during episiotomy repair in mothers of the SSC group was significantly lower than the control group (4.74±0.85 versus 5.34±0.81; P <0.01). Conclusions: Early SSC significantly improved the rate of exclusively breastfeeding at 6 weeks of age among healthy term neonates. An important additional effect was a decrease in the amount of pain that mothers in the SSC group experienced during episiotomy repair.

PREVALENCE OF IRON DEFICIENCY ANAEMIA AND DIETARY IRON INTAKE AMONG INFANTS AGED SIX TO NINE MONTHS IN KEIYO SOUTH SUB COUNTY, KENYA

The increased prevalence of iron deficiency among infants can be attributed to the consumption of an iron deficient diet or a diet that interferes with iron absorption at the critical time of infancy, among other factors. The gradual shift from breast milk to other foods and liquids is a transition period which greatly contributes to iron deficiency anaemia (IDA). The purpose of this research was to assess iron deficiency anaemia among infants aged six to nine months in Keiyo South Sub County. The specific objectives of this study were: to establish the prevalence of infants with iron deficiency anaemia and dietary iron intake among infants aged 6 to 9 months. The cross sectional study design was adopted in this survey. This study was conducted in three health facilities in Keiyo South Sub County. The infants were selected by use of a two stage cluster sampling procedure. Systematic random sampling was then used to select a total of 244 mothers and their infants. Eighty two (82) infants were selected from Kamwosor sub-district hospital and eighty one (81) from both Nyaru and Chepkorio health facilities. Interview schedules, 24-hour dietary recall and food frequency questionnaires were used for collection of dietary iron intake. Biochemical tests were carried out by use of the Hemo-control photochrometer at the health facilities. Infants whose hemoglobin levels were less than 11g/dl were considered anaemic. Further, peripheral blood smears were conducted to ascertain the type of nutritional anaemia. Data was analyzed using the Statistical Package for Social Sciences (SPSS) computer software version 17, 2009. Dietary iron intake was analyzed using the NutriSurvey 2007 computer software. Results indicated that the mean hemoglobin values were 11.3± 0.84 g/dl. Twenty one percent (21.7%) of the infants had anaemia and further 100% of peripheral blood smears indicated iron deficiency anaemia. Dietary iron intake was a predictor of iron deficiency anaemia in this study (t=-3.138; p=0.01). Iron deficiency anaemia was evident among infants in Keiyo South Sub County. The Ministry of Health should formulate and implement policies on screening for anaemia and ensure intensive nutrition education on iron rich diets during child welfare clinics.

Insulin-like growth factor-i : vitronectin complex-induced changes in gene expression effect breast cell survival and migration

Recent studies have demonstrated that IGF-I associates with VN through IGF-binding proteins (IGFBP) which in turn modulate IGF-stimulated biological functions such as cell proliferation, attachment and migration. Since IGFs play important roles in transformation and progression of breast tumours, we aimed to describe the effects of IGF-I:IGFBP:VN complexes on breast cell function and to dissect mechanisms underlying these responses. In this study we demonstrate that substrate-bound IGF-I:IGFBP:VN complexes are potent stimulators of MCF-7 breast cell survival, which is mediated by a transient activation of ERK/MAPK and sustained activation of PI3-K/AKT pathways. Furthermore, use of pharmacological inhibitors of the MAPK and PI3-K pathways confirms that both pathways are involved in IGF-I:IGFBP:VN complex-mediated increased cell survival. Microarray analysis of cells stimulated to migrate in response to IGF-I:IGFBP:VN complexes identified differential expression of genes with previously reported roles in migration, invasion and survival (Ephrin-B2, Sharp-2, Tissue-factor, Stratifin, PAI-1, IRS-1). These changes were not detected when the IGF-I analogue (\[L24]\[A31]-IGF-I), which fails to bind to the IGF-I receptor, was substituted; confirming the IGF-I-dependent differential expression of genes associated with enhanced cell migration. Taken together, these studies have established that IGF-I:IGFBP:VN complexes enhance breast cell migration and survival, processes central to facilitating metastasis. This study highlights the interdependence of ECM and growth factor interactions in biological functions critical for metastasis and identifies potential novel therapeutic targets directed at preventing breast cancer progression.

FOXC2 expression links epithelial-mesenchymal transition and stem cell properties in breast cancer

Resistance to chemotherapy and metastases are the major causes of breast cancer-related mortality. Moreover, cancer stem cells (CSC) play critical roles in cancer progression and treatment resistance. Previously, it was found that CSC-like cells can be generated by aberrant activation of epithelial–mesenchymal transition (EMT), thereby making anti-EMT strategies a novel therapeutic option for treatment of aggressive breast cancers. Here, we report that the transcription factor FOXC2 induced in response to multiple EMT signaling pathways as well as elevated in stem cell-enriched factions is a critical determinant of mesenchymal and stem cell properties, in cells induced to undergo EMT- and CSC-enriched breast cancer cell lines. More specifically, attenuation of FOXC2 expression using lentiviral short hairpin RNA led to inhibition of the mesenchymal phenotype and associated invasive and stem cell properties, which included reduced mammosphere-forming ability and tumor initiation. Whereas, overexpression of FOXC2 was sufficient to induce CSC properties and spontaneous metastasis in transformed human mammary epithelial cells. Furthermore, a FOXC2-induced gene expression signature was enriched in the claudin-low/basal B breast tumor subtype that contains EMT and CSC features. Having identified PDGFR-β to be regulated by FOXC2, we show that the U.S. Food and Drug Administration-approved PDGFR inhibitor, sunitinib, targets FOXC2-expressing tumor cells leading to reduced CSC and metastatic properties. Thus, FOXC2 or its associated gene expression program may provide an effective target for anti-EMT-based therapies for the treatment of claudin-low/basal B breast tumors or other EMT-/CSC-enriched tumors.

Development of an eight gene expression profile implicating human breast tumours of all grade

The goal of improving systemic treatment of breast cancers is to evolve from treating every patient with non-specific cytotoxic chemotherapy/hormonal therapy, to a more individually-tailored direct treatment. Although anatomic staging and histological grade are important prognostic factors, they often fail to predict the clinical course of this disease. This study aimed to develop a gene expression profile associated with breast cancers of differing grades. We extracted mRNA from FFPE archival breast IDC tissue samples (Grades I–III), including benign tumours. Affymetrix GeneChip� Human Genome U133 Plus 2.0 Arrays were used to determine gene expression profiles and validated by Q-PCR. IHC was used to detect the AXIN2 protein in all tissues. From the array data, an independent group t-test revealed that 178 genes were significantly (P B 0.01) differentially expressed between three grades of malignant breast tumours when compared to benign tissues. From these results, eight genes were significantly differentially expressed in more than one comparison group and are involved in processes implicated in breast cancer development and/or progression. The two most implicated candidates genes were CLD10 and ESPTI1 as their gene expression profile from the microarray analysis was replicated in Q-PCR analyses of the original tumour samples as well as in an extended population. The IHC revealed a significant association between AXIN2 protein expression and ER status. It is readily acknowledged and established that significant differences exist in gene expression between different cancer grades. Expansion of this approach may lead to an improved ability to discriminate between cancer grade and other pathological factors.

In vitro and in vivo MMP gene expression localisation by In Situ-RT-PCR in cell culture and paraffin embedded human breast cancer cell line xenografts

Background Members of the matrix metalloproteinase (MMP) family of proteases are required for the degradation of the basement membrane and extracellular matrix in both normal and pathological conditions. In vitro, MT1-MMP (MMP-14, membrane type-1-MMP) expression is higher in more invasive human breast cancer (HBC) cell lines, whilst in vivo its expression has been associated with the stroma surrounding breast tumours. MMP-1 (interstitial collagenase) has been associated with MDA-MB-231 invasion in vitro, while MMP-3 (stromelysin-1) has been localised around invasive cells of breast tumours in vivo. As MMPs are not stored intracellularly, the ability to localise their expression to their cells of origin is difficult. Methods We utilised the unique in situ-reverse transcription-polymerase chain reaction (IS-RT-PCR) methodology to localise the in vitro and in vivo gene expression of MT1-MMP, MMP-1 and MMP-3 in human breast cancer. In vitro, MMP induction was examined in the MDA-MB-231 and MCF-7 HBC cell lines following exposure to Concanavalin A (Con A). In vivo, we examined their expression in archival paraffin embedded xenografts derived from a range of HBC cell lines of varied invasive and metastatic potential. Mouse xenografts are heterogenous, containing neoplastic human parenchyma with mouse stroma and vasculature and provide a reproducible in vivo model system correlated to the human disease state. Results In vitro, exposure to Con A increased MT1-MMP gene expression in MDA-MB-231 cells and decreased MT1-MMP gene expression in MCF-7 cells. MMP-1 and MMP-3 gene expression remained unchanged in both cell lines. In vivo, stromal cells recruited into each xenograft demonstrated differences in localised levels of MMP gene expression. Specifically, MDA-MB-231, MDA-MB-435 and Hs578T HBC cell lines are able to influence MMP gene expression in the surrounding stroma. Conclusion We have demonstrated the applicability and sensitivity of IS-RT-PCR for the examination of MMP gene expression both in vitro and in vivo. Induction of MMP gene expression in both the epithelial tumour cells and surrounding stromal cells is associated with increased metastatic potential. Our data demonstrate the contribution of the stroma to epithelial MMP gene expression, and highlight the complexity of the role of MMPs in the stromal-epithelial interactions within breast carcinoma.