Background
Breast cancer is one of the most common malignancies affecting women in Western countries [
1]. Despite extensive research efforts worldwide at understanding and eradicating breast cancer, the cellular processes that lead to the onset of mammary carcinogenesis have yet to be definitively elucidated. Oxidative stress has come under increasing scrutiny in recent years as a causative factor in mammary carcinogenesis. Chronic infection and inflammation, which lead to reactive oxygen species (ROS) generation, are recognized risk factors for cancer development [
2]. 17β-Estradiol (E2) [
3‐
6] and epidermal growth factor (EGF) [
7,
8], two agents that can increase intracellular oxidative stress, are also strongly linked to the development of breast cancer. E2 binding to estrogen receptor (ER) [
9‐
11] and EGF's known properties as a growth factor, [
1,
12] as well as its putative role in modulating ER expression [
13,
14], could also lead to cell transformation through the induction of cellular proliferative responses.
Epidemiological evidence and the recognized risk factors implicate estrogens as important etiological agents in the development of breast cancer [
9,
15‐
20]. The exact mechanism(s) by which estrogen contributes to the development of breast cancer has not yet been elucidated. Most studies to date have focused on estrogen's role as a promoter of carcinogenesis based on its proven mitogenic activity in cells [
9,
10,
21]. Receptor-based increases in cell proliferation due to estrogen binding are thought to act by either increasing spontaneous errors that make target tissues more susceptible to initiation or enhancing the replication of clones of already initiated target cells [
10]. Increasingly, however, the notion that estrogen can function as an initiator of breast cancer
via ROS generation and consequent oxidative DNA damage is gaining experimental support [
3‐
5,
21‐
24].
Over two decades ago, J. Liehr and coworkers elegantly demonstrated that while 17β-estradiol (E2) exposure induces renal clear-cell carcinoma in Syrian hamsters, 2-fluoroestradiol (2-Fl-E2), a fluorinated estrogen analog that is a potent estrogen but displays reduced metabolic conversion to catechol estrogen metabolites, was non-carcinogenic in this system [
25,
26]. Oxidation of cytochrome P450-catalyzed catechol estrogen (CE) metabolites, particularly 4-hydroxyestradiol (4-OH-E2), to semiquinones and quinones and their redox cycling, is thought to generate free radicals which can effect oxidative DNA damage [
22,
23,
27,
28] leading to mutations and carcinogenesis. 4-OH-E2 is the predominant catechol formed in human mammary fibroadenomas and adenocarcinomas tested [
29]. The localized occurrence of a specific estrogen 4-hydroxylase (CYP1B1) in human breast cancer cells, uterine myoma, and rodent target organs of estrogen-induced carcinogenesis has also been observed [
29]. Further, formation of 8-hydroxy-2'-deoxyguanosin (8-OHdG) was higher in ERα-positive cultured human breast cancer cells and tissues in comparison to ERα-negative cells [
30]. Studies conducted with human sperm and lymphocytes provided evidence that exposure to various estrogenic compounds can lead to free radical-mediated damage as well. This damage was diminished in nearly all cases by catalase, indicating that estrogen-mediated effects act
via hydrogen peroxide (H
2O
2) production [
31].
ERα levels can be modulated by EGF [
13,
14], which was shown to increase oxidative DNA damage in mammary tumor cells coincident with increased malignancy [
7]. EGF, a growth factor regulating the proliferation and differentiation of human mammary epithelial cells, is thought to be involved in the pathophysiology of breast cancer [
1,
12]. Underscoring its significance in mammary carcinogenesis, EGF is present in several human breast cancer cell lines and in 15-30% of human primary invasive breast carcinomas; its mRNA is elevated in ERα-positive human breast cancer cell lines and tumors, and its expression correlates with poor prognosis in breast cancer patients [
1]. EGF by itself can increase H
2O
2 levels [
7,
8] and, thus, may be a critical factor in oxidative stress-induced breast cancer.
The culture medium of MCF-10A cells is usually supplemented with various factors such as hydrocortisone (HC), EGF, and phenol red (PHR, a pH indicator), which can affect redox state as well as ER activity. We observed in this study that MCF-10A cells left in continuous culture for prolonged periods without re-feeding were prone to the development of morphologically transformed foci. Our hypothesis was that the depletion of labile culture components induced oxidative stress and led to the onset of spontaneous transformation. However, deliberate manipulation of culture components and treatment with redox active and inactive estrogens indicated both oxidative stress- and ERα-mediated pathways to be operative in the spontaneous transformation of these cells. While MCF-10A cells are characterized as ERα-negative, gene array and western blotting analyses of cells maintained in our laboratory as well as of those obtained from a variety of different sources provided documentation of detectable ERα and ERbeta (ERβ) in this cell line. Western blotting analysis also indicated for the first time the possibility of a direct association of epidermal growth factor receptor (EGFR) and ERα in the MCF-10A cell line as well as the formation and high induction of a novel ternary complex that includes ERβ (ERα/ERβ/EGFR) in MCF-10A cells grown under conditions facilitating their transformation.
Materials and methods
A. Cells and Materials
MCF-10A cells were purchased from American Type Culture Collection (ATCC; Manassas, VA). MCF-10A cells were also kindly provided by Drs. J.D. Yager (Department of Environmental Health Science, The Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD; Source #1), K. Eckert (Gittlen Cancer Research Institute, Penn State College of Medicine, Hershey, PA; Source #2), M. Planas-Silva (Department of Pharmacology, Penn State College of Medicine, Hershey, PA; Source #3), and M. F. Verderame (Department of Medicine, Penn State College of Medicine, Hershey, PA; Source #4). The laboratories at Penn State University that kindly provided MCF-10A cells had obtained these cells independently of one another from different sources. A custom formulation of PHR-free Dulbecco's Modified Eagle's Medium/Nutrient F12 (DMEM/F12) cell culture medium D231SA, trypsin (0.25%, 1×), trypsin-ethylenediaminetetraacetic acid (trypsin-EDTA; 0.05% trypsin, 0.53 mM EDTA, 1×), L-glutamine (200 mM, 100×), and antibiotic/antimycotic (100×) solutions were purchased from Atlanta Biologicals (Norcross, GA). Horse serum (HS) was purchased from Invitrogen (Carlsbad, CA). EGF was purchased from R&D Systems (Minneapolis, MN). Protease inhibitor cocktail tablets were obtained from Roche Molecular Biochemicals (Indianapolis, IN). All other reagents were purchased as described in the text or from Sigma Chemical Company (St. Louis, MO).
B. Cell Culture
MCF-10A cells were maintained in PHR-free DMEM/F12 culture medium unless otherwise specified. Medium was supplemented with NaHCO3 (1200 mg/L), CaCl2 (1.05 mM), 5% HS, insulin (10 μg/ml), L-glutamine (2 mM), antibiotic/antimycotic mixture (1%), EGF (20 ng/ml), HC (500 ng/ml), and cholera toxin (100 ng/ml). Cells were fed twice a week and grown to confluence before subculturing. Briefly, cells were washed once with Dulbecco's Phosphate Buffered Saline (D-PBS) and exposed to trypsin for 15-20 minutes before the action of trypsin was stopped with 20% HS-supplemented medium. Cells were then centrifuged at 100 × g in a tabletop centrifuge for 5 min and the cell pellet was resuspended in medium and transferred to other flasks. All cells were grown in a single chamber water-jacketed humidified incubator and maintained in a 37°C, 5% carbon dioxide (CO2) atmosphere. The number of passages cells have been propagated in a particular type of medium is indicated in parentheses next to the description of the medium [(i.e. -HC/-EGF (#10)]
C. Assay for Morphologic Transformation
MCF-10A cells maintained in PHR-free 5% HS-supplemented, HC and EGF-containing [+HC/+EGF (+/+)] DMEM/F12 medium were subsequently grown for the 5-week morphologic transformation assay in +/+, -HC/-EGF (-/-), -HC/+EGF (-/+), or +HC/-EGF (+/-) DMEM/F12 media supplemented with 0.5% HS and 240 μg bovine serum albumin (BSA)/ml in the absence or presence of PHR. Cells in these eight medium groups were non-treated (NT) or treated with 0.01% ethanol (EtOH) alone or with 0.01% EtOH solution of 1 nM E2 or 1 nM 2-fluorestradiol (2-Fl-E2). Initially, cells were either left untreated or treated with appropriate agents and then plated in triplicate in 6-well plates at a density of 5 × 105 cells/well. Thereafter, cells were maintained in continuous culture for 6 weeks, refed and re-treated once a week, and examined microscopically each week for signs of contact-uninhibited growth and the appearance of morphologically transformed foci. Transformed foci were counted once a week from 1-5 weeks at 4× magnification as they appeared along two perpendicular lines intersecting in the center of each well. To assess the reversibility of phenotypic cell alterations, after five weeks, PHR, HC, and EGF were added back singly or together, to cultures that were lacking these factors, and the number of transformed foci was again determined at week 6. The assay was performed once with duplicates of each treatment analyzed. Some treated cells were plated in poly-D-lysine-coated tissue-culture plates in an attempt to increase detailed microscopic visualization and examination of foci.
D. Western Immunoblotting Analysis
Cells used for Western blot analysis included MCF-10A cells (non-treated and treated under various treatment protocols and media conditions) as well as MCF-10A cells acquired from different laboratories and grown in -PHR, 5% HS, +/+ medium. Total cell extracts were obtained by first trypsinizing and pelleting cells as described in section B of Materials and Methods and washing once with D-PBS. Cell lysis buffer [5.0 M EDTA, 150 mM NaCl, 50 mM Tris HCl, 1% Triton X-100, 1% SDS, 50 mM dithiothreitol (DTT), and protease inhibitor cocktail tablets (1 tablet per 10 ml buffer)] was added to each tube at 100 μl buffer per 1 × 106 cells and mixed well to lyse the cells completely. Lysates were transferred to microcentrifuge tubes, incubated on ice for 10-30 min., and centrifuged at 12,000 × g in a microcentrifuge at 4°C for 15 min. The supernatants were collected and stored at -80°C for subsequent analyses. Alternately, Pierce (Rockford, IL) NE-PER Nuclear and Cytoplasmic Extraction Reagents were used as per the manufacturer's protocol for the stepwise separation and preparation of cytoplasmic and nuclear extracts. Protein content was measured using Bradford Reagent. Proteins (25-30 μg) were resolved by SDS-PAGE in 12% SDS-Tris-HCl polyacrylamide mini-running gels and transferred onto nitrocellulose membranes (BioRad Laboratories; Hercules, CA). Membranes were incubated with primary antibodies to ERα, ERβ, or EGFR at a dilution of 1:1000 in 5% non-fat dry milk-Tris Buffered Saline/Tween (TBS/T) buffer at 4°C overnight, followed by incubation with both the appropriate horseradish peroxidase (HRP)-conjugated secondary antibody at a dilution of 1:10,000 and anti-biotin antibody at 1:1000 dilution in 5% non-fat dry milk in TBS/T at room temperature (RT) for 1 h. Protein was detected using the Western Lightning Chemiluminescent Reagent Plus Kit from PerkinElmer (Wellesley, MA) as per the manufacturer's directions. Antibodies (Ab) and controls used were: ERα (62A3) mouse monoclonal Ab, EGFR rabbit polyclonal Ab, and anti-biotin Ab (Cell Signaling Technology; Beverly, MA); ERβ (PA1-313) rabbit Ab, human, recombinant ERα RP-310 and ERβ (long form) RP-312 (Affinity BioReagents; Golden, CO); EGF-stimulated A431 cell lysate (Upstate Biotechnology; Lake Placid, NY). Peroxidase-conjugated Immunopure goat anti-mouse and sheep anti-rabbit IgG's were used as secondary antibodies (Pierce Chemical Company, Rockford, IL)
E. Gene Expression Analysis of the Human Toxicity/Stress and Estrogen Signaling Pathways
Cells were trypsinized and pelleted according to the protocol outlined in Section B, and RNA was isolated from cells using the RNAqueous RNA isolation system (Ambion, Inc.; Austin, TX) according to the manufacturer's protocol. Immediately afterwards, contaminating DNA was removed using Ambion's "DNA-free" DNase Treatment and Removal Reagents again as per the manufacturer's directions. The RNA supernatants were transferred to new RNAse-free tubes and stored at -80°C. Prior to use in gene expression studies, the concentration and purity of RNA was determined by aliquoting a small amount of the samples in HPLC-grade, RNase-free dH2O and measuring absorbance at 260 nm and 280 nm. RNA concentration was calculated using a value of 1A260 nm = 40 μg RNA/ml. and its purity assessed by confirming that the ratio of A260/A280 was near 2.0. Nonrad-GEArray Kit Pathway Specific Gene Expression Profiling System (SuperArray, Inc; Bethesda, MD) was used for the analysis of gene expression after RNA isolation. The detailed manufacturer's protocol was followed for analysis. Briefly, biotinylated cDNA probes were synthesized from 5-10 μg total RNA by reverse transcription using a PCR thermal cycler and SuperArray reagents. Afterwards, cDNA probes were hybridized using a mini hybridization incubator kit reagents to pathway-specific gene expression array membranes (either human toxicity/stress or estrogen signaling) provided by the manufacturer. Finally, membranes were incubated with alkaline phosphatase (AP)-streptavidin, and chemiluminescent detection was performed with the provided CDP-Star substrate and immediate exposure to x-ray film between 0-5 min. Signal intensities were quantitated (semi-log) using UN-SCAN-IT digitizing software (Silk Scientific; Orem, UT) after the x-ray films were scanned onto a computer. Sample signal intensities were normalized against a housekeeping gene's signal intensities. Each membrane contained two spots for each cDNA analyzed. Means of the intensity (in pixels) of the duplicate spots were used for analysis
F. Statistical Analysis
Significance of differences between two groups was assessed using one-tailed Student's "t" test assuming unequal variances. One-way ANOVA followed by Dunnet's test was utilized to compare all groups to a control group, while One-way ANOVA followed by Tukey's test was used to compare all groups to each other. For all tests, p < 0.05 was considered significant.
Discussion
The mandatory depletion of HC, a potent anti-inflammatory agent thought to decrease oxidative stress in cells, in order to transform cells suggests that an oxidant milieu is critical to the carcinogenic process (Figs.
1 &
2). However, re-addition of HC, significantly (p < 0.01), but only partially, reversed the morphologic transformation seen in 5-week -/- MCF-10A continuous cultures (Table
2). The inhibitory effect of added HC on cell transformation and the reversible nature of its action have been documented in various cell types [
36‐
38]. For example, the presence of HC reversibly mediated growth inhibition as well as anchorage-dependence of rat C6 glioma cells and blocked colony formation in agarose [
36,
37]. HC-mediated ROS suppression [
39,
40], decrease of nuclear NF-κB [
41], and increases in antioxidant enzymes [
42] are likely responsible for such transformation-retarding effects.
Transformation of MCF-10A cells, however, was also dependent on the simultaneous depletion of EGF from the culture medium (Figs.
1 &
2); hence, EGF withdrawal-mediated ROS generation could play a role in such transformation. In mouse proximal tubular (MPT) cells, EGF deprivation was shown to elevate cellular superoxide anion radical levels and induce apoptosis [
43]. However, by itself, EGF can trigger H
2O
2 production [
7,
8] and thus, the finding that its presence inhibits transformation supports the possible outgrowth of EGF-independent clones and suppression of EGFR activity as important events in the transformation pathway [
44,
45] as well. In fact, adding back EGF, both by itself or with HC resulted in a slight increase in the number of foci (Table
2) and points to the possible outgrowth of EGF-autonomous cells, which then become hypersensitive to the action of EGF perhaps due to the acquisition of a constitutively active EGFR pathway. Lack of EGF in cell culture medium has previously been linked to the spontaneous transformation of HMT-3522 cells [
46,
47], to carcinogen-initiated neoplastic transformation of Syrian golden hamster pancreatic duct cells [
48], and to benzo[a]-pyrene (BP)-enhanced cell proliferation in MCF-10A cells [
49].
Our studies showed that transformation rates of MCF-10A cells treated with 1 nM E2 were elevated by over 5-fold in comparison to those of EtOH controls, only within a pre-existing oxidant microenvironment generated by HC and, possibly, EGF depletion (Table
1). The probability that E2-mediated transformation relies on the generation of ROS is indicated by the observation that 1 nM 2-Fl-E2, an estrogen whose metabolism leads to the formation of lower levels of oxidants [
4,
25‐
27,
50], is incapable of increasing transformation in MCF-10A cells over EtOH controls (Table
1). Studies previously conducted in animals and in various cell models implicate estrogens in transformation, ROS generation, and oxidative DNA damage, particularly 8-OHdG [
25,
28,
30‐
32,
51,
52]. Yet, our data also implicated estrogen receptor-mediated effects on cellular transformation. MCF-10A cells exposed to E2 are refractory to transformation even in the absence of HC (-/+ cultures) but in the presence of EGF (Figs.
1 &
2; Table
1), implying a need for the possible upregulation of ER-α, due to EGF withdrawal, within the carcinogenic process in this model. Low EGF concentrations in a low serum-containing medium stimulated growth of high ERα-expressing human breast cancer cell lines A431 and BT20, while high EGF doses inhibited their growth [
53]. Taken together, the data implicate EGF independence and E2-generated ROS and/or ERα-mediated events as possible contributors to MCF-10A transformation.
The presence of ERα in this ERα-negative categorized cell line and its importance in transformation is underscored by observed transformation suppression in the presence of PHR (Figure
3; Table
1) at 5 days (data not shown), 13 days (Fig.
1), and 5 weeks (Fig.
2). PHR, a known weak estrogen [
32,
33] used as a pH indicator at a concentration of 15-45 μM in most tissue culture media, can bind to the ERα of MCF-7 human breast cancer cells at an affinity of 0.001% of E2 and was seen to reduce ERα-mediated growth stimulatory processes of exogenous estrogens [
32]. The PHR concentration of media used in the present study (21.5 μM) could, therefore, effectively have blocked E2-mediated hormonal and/or oxidative effects on foci formation, as was observed. MCF-10A cells are normally cultured in medium supplemented with horse serum (HS), which contains estradiol. It is possible that chronic exposure of MCF-10A cells to picomolar (~6 × 10
-12 M) estradiol contained in HS led to upregulated ERα expression and contributed in part to the transformation of MCF-10A cells seen in -/- medium even in the absence of added E2 (NT and ethanol controls). We found that ERα-mediated events in MCF-10A cell transformation most likely constitute irreversible alterations since re-introducing PHR to culture medium had no effect on the number of foci, once formed (Table
2).
Gene expression arrays confirmed the expression of both ERα and ERβ in MCF-10A cells (Table
3) as well as estrogen responsive genes (Tables
4 &
5). The persistent, detectable levels of ERα and ERβ observed among varying culture conditions and treatments (Table
3), even in cells newly purchased from ATCC, provide evidence contradicting the classification of the MCF-10A cell line as ERα-negative. Hormonal estrogen responsiveness was also indicated by the observation that a 1 nM E2 treatment of -/- MCF-10A cultures upregulated prolactin (PRL) gene expression by > 6-fold, while it down-regulated progesterone receptor (PR) gene expression by >2-fold (Table
4). Such modulation has important implications for mammary cell differentiation/proliferation and cancer development. Pituitary prolactin levels are known to be increased due to exposure to exogenous estrogens [
54], promote mammary cancer in rats and mice [
55] and can activate Ras in rat lymphoma cells [
56] with recent studies linking circulating levels to breast cancer [
57]. PR, as well, is known to induce mammary epithelial cell proliferation [
58,
59] and contribute to mammary tumorigenesis [
58]. Similar to our findings, suppression of PR gene expression in human breast epithelial cells ML-20 and KPL-1 within a hypoxic microenvironment promoted malignancy [
60]. Interestingly, we noted that HC withdrawal was noted to modulate expression of estrogen responsive genes pS2, EBAG9, and PRL and genes involved in estrogen signaling such as EGF, c-fos, c-jun, c-myc, and H-ras (Table
5), which may be the result of an attempt by the cell to combat oxidative stress-induced cellular transformation.
The reasons for down-regulated EGF expression due to HC withdrawal are unclear. However, the presence of EGF inhibited MCF-10A foci formation even when cells were continuously treated with E2 (Table
1). EGF withdrawal was previously documented to transform human breast epithelial cell line HMT-3522, where EGFR suppression was posited to promote estrogen-responsive breast cancer [
44,
45]. As well, low EGF levels present in low serum-containing medium stimulated growth of human breast cancer cell lines A431 and BT20, expressing high ERα levels, while high EGF concentrations inhibited cell growth [
53]. Interestingly, in EGF-depleted MCF-10A cells, increased ROS generation due to benzo[a]pyrene-quinone (BPQ) exposure was seen to activate EGFR [
49]. In other studies, redox regulation of ER was also apparent, where H
2O
2-induced oxidative stress in MCF-7 and T-47 D human breast cancer cells led to a minimal upregulation of ER-α but a significant increase in ER-β levels [
61]. The initial depletion of HC and EGF from the growth medium of MCF-10A cells could lead to the upregulation of ER expression due to both EGF withdrawal-mediated effects and elevated oxidative stress. At the same time, increased oxidant levels concomitant with EGF-withdrawal may also activate EGFR in these cells. EGF hypersensitivity was already noted in our system (Table
2).
Further support for increased ER and EGFR activities due to increased oxidative stress and concomitant EGF withdrawal was provided by the possible existence of a novel, yet still highly speculative, direct association of EGFR and ERα in MCF-10A seen to be induced and believed to include the presence of ERβ in chronic HC/EGF-depleted MCF-10A cells (Fig.
7), which are the most prone to transformation. A puzzling observation in the Western blots showing this ternary complex formation is the presence of the ~200 kD band in lanes containing the recombinant proteins ERα and ERβ synthesized in baculovirus-infected Sf9 cells (Fig.
7a-b; lanes 1 & 9 and Fig.
7c-d; lanes 2 & 10). This observation can only be explained by copurification of these recombinant proteins with contaminating host EGFR proteins. Yet, Sf9 are insect spodoptera frugiperda cells do not contain human EGFR. However, Sf9 cells do contain a growth-blocking peptide receptor (GBPR) having a tyrosine phosphorylation subunit, which can bind human EGF, and can be detected in gels by probing with anti-human EGFR antibody [
62]. Thus, association of GBPR with ERα or ERβ during their synthesis in Sf9 cells would explain the presence of the ~200 kD band in bands containing the recombinant proteins and probed with their respective antibodies. Detection of the ~200 kD band in lanes containing both recombinant ERα and ERβ indicate that GBPR can associate with both proteins, yet these bands would not cross-react with both ERα and ERβ antibodies, as seen, since only one protein would be synthesized at a time in Sf9 cells. The absence of a ~200 kD band in lanes containing recombinant ERα or ERβ in gels probed with EGFR antibodies (Fig.
7e-f; lanes 1-2 & 9-10) may be due to the fact that the EGFR moiety detected by the particular EGFR antibody used is not present in GBPR.
Induction of this, as yet speculative, ERα/ERβ/EGFR ternary complex formation may provide an explanation and plausible mechanism for the increased EGF and E2 sensitivity noted in the transformation of this cell line. Chronic withdrawal of HC/EGF from MCF-10A cell cultures seems to strongly facilitate the formation of this putative ERα/ERβ/EGFR ternary complex, a possible manifestation of the ER and EGFR upregulation induced by increased ROS and EGF deficiency in the microenvironment, thereby conferring both EGF and E2 hypersensitivity to cells. While work by other laboratories have implicated either ER or EGFR upregulation/activation due to the actions of EGF withdrawal and increased oxidative stress either by themselves or together, the present study indicates increased activation of both ER and EGFR in the MCF-10A cell line due to the simultaneous effects of both increased oxidant stress and EGF withdrawal. The transformation-enhancing action of such EGF and E2 hypersensitivity can be mediated by the induction of this possible ERα/ERβ/EGFR ternary complex noted to occur under EGF-deficient, pro-oxidant conditions. Marquez
et al. have also demonstrated a novel direct interaction between ER and EGFR after EGF treatment of MCF-7 cells where EGFR tyrosine kinase phosphorylates ERα at tyrosine-537 and tyrosine-43, possibly leading to estrogen-independent activation of ER-mediated transcription and cell proliferation [
63,
64]. Others have reported similar results [
65]. Proteins recognized by ER-α and ER-β monoclonal antibodies were found in close association to EGFR in lung tumor cells [
66]. As well, estrogen was seen to promote an association between extranuclear ER-α and the EGFR family member ERBB4 in the T47 D breast cancer cell line [
67]. Such cross-talk can activate diverse downstream signal transduction pathways which regulate cell proliferation [
66,
68]. In addition, bi-directional cross talk between ER and EGFR can enhance the individual actions of steroids [
69]. Thus, augmented cell proliferation and survival responses [
14,
63,
70‐
72] due to ER/EGFR interactions in MCF-10A cells can possibly lead to their transformation. Several laboratories have posited the probable co-existence and/or necessity for ER-mediated proliferative effects and CE-mediated genotoxic and oxidative events in carcinogenic process [
20,
73,
74]. Results from the present study indicate this to be the case in the transformation of MCF-10A cells.
Authors' contributions
RY conceptualized the study, designed and carried out all experiments, analyzed the data, carried out the statistical analyses, and drafted the manuscript. KF provided substantial intellectual input into the conceptualization and design of the study, interpretation of the data, and revision of the manuscript for final submission. All authors have read and approved the final manuscript.