MMP9 and medical procedure: In addition, the THP-1 differentiated macrophages incubated in the presence of CM obtained from ObR sh clones, exhibited a decreased expression of cytokines sustaining the multistep development of breast malignancy involved in tumor angiogenesis, invasiveness and metastasis (e.g., MCP-1, VEGF, MMP-9) [57,58,59,60], in EMT and stemness (TNF-α, IL-6) [53,61] and in immunosuppressive effects (IL-10) [62].