This research was supported by Cancer Research Foundation / Swiss Cancer League grant KFS-4125-02-2017 to RKD and National Institute of Health grant DK079307 to EKJ.

1. Cell culture
NOTE: Conduct cell handling under sterile conditions.
<ol>
	<li>Human Umbilical Vein Endothelial Cells (HUVECs) subculture
	<ol>
		<li>Coat 75 cm2 flasks with collagen (5 &#181;g/cm2) (rat-tail) overnight (ON) at room temperature (RT) or 2-3 h at 37 &#176;C, rinse with water, and allow the flask to dry.</li>
		<li>Grow HUVECs in growth medium (EBM-2, Endothelial Basal Medium-2) supplemented with glutamine (1x = 2 mM), antibiotic-antimycotic solution (AA; 100 &#181;g/mL of streptomycin, 100 &#181;g/mL of penicillin and 0.025 &#181;g/mL of amphotericin B), LSGS (2% v/v FCS, 1 &#181;g/mL of hydrocortisone, 10 ng/mL of human Epidermal Growth Factor, 3 ng/mL of human basic Fibroblast Growth Factor, 10 &#181;g/mL of heparin) and 10% FCS (Fetal Calf Serum) under standard tissue culture conditions (37 &#176;C, 5% CO2). Change the medium every 2 days until the cells reach 70%-80% confluence.</li>
		<li>Wash the sub-confluent cultures with 5 mL of HBSS (without Ca2+ and Mg2+) and add 3 mL of trypsin (0.25% diluted in HBSS (without Ca2+ and Mg2+)). 
		NOTE: HBSS can also be replaced with PBS.</li>
		<li>Incubate the cells at 37 &#176;C for 2 min (microscopically check whether the cells are detached and rounded up) and stop the detaching reaction by adding 6 mL of 10% FCS medium (DMEM-F12 or EBM-2, 10% FCS).</li>
		<li>Centrifuge the cell suspension at 250 x g for 5 min at RT and discard the supernatant.</li>
		<li>Suspend the cells in growth medium and seed in 75 cm2 flasks or culture dishes.</li>
	</ol>
	</li>
	<li>Michigan Cancer Foundation-7 (MCF-7, human breast adenocarcinoma cells) subculture
	<ol>
		<li>Grow human breast cancer cell lines in 75 cm2 flasks in growth medium (DMEM/F12 medium supplemented with a commercial glutamine (1x), antibiotic-antimycotic solution (AA; 100 &#181;g/mL of streptomycin, 100 &#181;g/mL of penicillin and 0.025 &#181;g/mL of amphotericin B), and 10% FCS&#160;under standard tissue culture conditions (37 &#176;C, 5% CO2). Change the medium every 2-3 days.</li>
		<li>Wash the subconfluent cell cultures (70%-80% confluence) with 5 mL of HBSS (without Ca2+ and Mg2+) and add 3 mL of trypsin (0.5% diluted in HBSS (without Ca2+ and Mg2+) at 37 &#176;C for 5 min (microscopically verify that the cells are detached). 
		NOTE: HBSS can also be replaced with PBS.</li>
		<li>Add 8 mL of 10% FCS medium to stop the detaching reaction, centrifuge at 250 x g for 5 min at RT and discard the supernatant.</li>
		<li>Suspend the pellet in growth medium and plate in 75 cm2 flasks or culture dishes.</li>
	</ol>
	</li>
</ol>
2. Spheroid formation
<ol>
	<li>Plate 5 x 105 cells/mL (HUVECs and MCF-7) in a 3.5 cm round dish and culture for 48 h.</li>
	<li>Treat or transfect the plated cells for 24 h or as desired.</li>
	<li>Optional step performed in 96-well U-bottom plate: Wash the cells with 1 mL of HBSS (Ca2+ and Mg2+) and stain HUVECs using a blue dye (0.5 &#181;g/mL) and MCF-7 cells using a green dye (0.5 &#181;M) diluted in the respective growth medium and place into a 37 &#176;C and 5% CO2 incubator for 30-40 min.</li>
	<li>Wash the cells with 1 mL of HBSS (without Ca2+ and Mg2+), add 1 mL of enzymatic detachment reagent (0.25% trypsin for HUVEC and 0.5% trypsin for MCF-7) to each round dish using a P1000 pipette, and then incubate for 2-5 min until the cells are detached.</li>
	<li>Collect each cell type separately in a 5 mL round-bottom Polystyrene tube and add 1 mL of 10% FCS medium using a P1000 pipette to stop the enzymatic reaction. Centrifuge the cell suspensions at 250 x g for 5 min.</li>
	<li>Carefully aspirate the supernatant and suspend the cells in 1 mL of steroid-free medium (EBM-2, glutamine , antibiotic-antimycotic, 0.4% FCS sf (charcoal-stripped)). 
	NOTE: Steroid-free medium can be replaced with normal growth medium.</li>
	<li>Use 100 &#181;L of each cell suspension diluted with 10 mL of Diluent II (see Table of Materials) to determine the total cell number and calculate the amount of treatment medium (EBM-2, glutamine, antibiotic-antimycotic, 0.4% FCS sf, vehicle/Treatment) needed to obtain a cell suspension of 5 x 103 cells/mL or 3.4 x 105 cells/mL per cell type.
	<ol>
		<li>Cell count
		<ol>
			<li>Turn on the machine and flush by pressing the Function and Start buttons (set-up S3), with Diluent II solution in a cell counter vial.</li>
			<li>Use set up S4 and press Start to measure the blank with fresh Diluent II solution.</li>
			<li>Change the scintillation vial with 100 &#181;L of cell suspension in 10 mL of Diluent II solution and measure the samples: set-up S4 and press Start.</li>
			<li>Note the number of cells per mL on the digital display. 
			&#8203;NOTE: Cell counting can also be performed using other manual or automatic systems: Hemocytometer gridlines, light-scatter cell-counting technology, electrical impedance, imaging-based systems using cell staining, e.g., trypan blue.</li>
		</ol>
		</li>
		<li>96-well U-bottom plates
		<ol>
			<li>Prepare 5 mL of each cell suspension (5 x 103 cells/mL) and mix them to get a final volume of 10 mL in the ratio of 1:1.</li>
			<li>Use a manual repeating pipette to pipette out 100 &#181;L of the cell suspension into each well of the 96-well U-bottom plates.</li>
			<li>Place the plate into an incubator under standard tissue culture conditions and check for spheroids formation after 48 h.</li>
			<li>Optional step: Take pictures of the spheroids (40x) using a fluorescence stereo microscope. 
			NOTE: This method generates 96 spheroids (one spheroid/well) after 48 h (area 1-2 pixel2), and it is usually used for growth studies.</li>
		</ol>
		</li>
		<li>Hanging drop
		<ol>
			<li>Mix the cell suspensions (3.4 x 105 cells/mL) in a 1:1 ratio to get a final volume of 2 mL.</li>
			<li>Use a P20 pipette to seed the cell mixture in the form of 15 &#181;L drops on the inverted lid of a 10 cm Petri dish.</li>
			<li>Invert the lid with the drops and add 5 mL of base medium (EBM-2) at the bottom of the dish to avoid evaporation of the drops. 
			&#8203;NOTE: This method generates one spheroid/drop after 48 h. Ensure the drops are sufficiently apart from each other, so that they do not merge while switching the lid. Use more than one 10 cm Petri dish if necessary.</li>
		</ol>
		</li>
	</ol>
	</li>
</ol>
3. Spheroid growth study
<ol>
	<li>Plate 100 &#181;L of HUVECs and MCF-7 cell mixture (5 x 102 cells/well) in 96-well U-bottom plates and place them in the incubator.</li>
	<li>48 h after plating, check for spheroids formation with an inverted microscope (Bright field). Take pictures (at least six pictures per treatment, 40x) at 96 h of culture.</li>
	<li>Open the pictures using an image processing software and process the image to 300 pixel/inch and save the image as a tiff file.</li>
	<li>Download the ImageJ software and open it. Click on the File option and go to Open.</li>
	<li>Convert the areas of interest to saturated black areas in a uniform manner to have a binary image (black and white). For this, select the Image option, choose Type | 8-bit. Now, the image is black and white.</li>
	<li>Use the Freehand Selection Tool to draw the border of the spheroids.</li>
	<li>To calculate the area of interest and to separate the object or the foreground pixels from the background pixels, use the threshold function: Select the Image option, choose Adjust and click on Threshold.</li>
	<li>Now a Threshold pop-up window will open. The top bar indicates the minimum threshold value: set the value at zero. The bottom bar indicates the maximum threshold value: move the bar until the area of interest becomes completely red. 
	NOTE: If the color is not red, select Red from the Threshold window.</li>
	<li>Go to Analyze | Set Measurements and select Area and Perimeter.</li>
	<li>To measure the area of interest, select the Analyze option and use the Analyze Particles tool. In the Analyze Particles window, set the Size to measure (0.00003-Infinity or 3-Infinity, depending on the size of the spheroids), select Summarize and Display Results. Then, click on OK.</li>
	<li>The results will show up in a chart. Copy the measurements into a spreadsheet to analyze the data. 
	&#8203;NOTE: The area is calculated as the number of total pixels; use the Total Area for calculation.</li>
</ol>
4. Spheroid immunohistochemistry study
<ol>
	<li>Sample preparation
	<ol>
		<li>Plate the cell mixture of HUVECs and MCF-7 (5 x 103 cells/well) in 96-well U-bottom plates in HUVEC growth medium for 96 h.</li>
		<li>Collect approximately 50 spheroids into a 1.5 mL tube with a cut tip of a P200 &#181;L pipette; allow them to settle to the bottom of the tube by gravity, and then discard the supernatant.</li>
		<li>Fix the spheroids with 500 &#181;L of 4% PFA for 1 h, RT.</li>
		<li>Boil 2% Nobel Agar solution in PBS usinga hot plate with a magnetic stirrer for 3-5 min to dissolve the agarose powder completely and cool down to around 60 &#176;C.</li>
		<li>Remove the PFA with a P1000 pipette, wash the spheroids with 500 &#181;L of PBS, and allow them to sediment. Discard the supernatant.</li>
		<li>Carefully pipette 600 &#181;L of agarose solution into the 1.5 mL tube with spheroids and place the tube immediately in a centrifuge with a horizontal rotor at 177 x g for 2 min.</li>
		<li>Add a short string in the middle of the agarose solution to easily remove the plug from the tube.</li>
		<li>Solidify agarose plug on ice or at 4 &#176;C. Add 500 &#181;L of PBS into the 1.5 mL tube to avoid drying out of the pellet. 
		&#8203;NOTE: The samples are ready for subsequent dehydration, paraffin embedding, sectioning, transfer onto the microscope slides, and IHC staining (performed by Sophistolab).</li>
	</ol>
	</li>
	<li>Image acquisition and processing
	<ol>
		<li>Acquire images of spheroid sections using a stereomicroscope.</li>
		<li>Save three images for each sample as .jpg files.</li>
		<li>Open the ImageJ software. Open the JPEG image, click on File and then on Open.</li>
		<li>Select Color and Color Deconvolution in the Image option.</li>
		<li>Select H DAB vectors in the Color Deconvolution 1.7 window, and the three images appear. 
		NOTE: The three images are: Color 1 represents only the Hematoxylin staining (blue/purple), and Color 2 represents only the DAB staining (brown). Color 3 is not needed for the image analysis with two stainings.</li>
		<li>Select the Color 1 window and set the Threshold: go to Image | Adjust and click on Threshold. The Threshold window appears.</li>
		<li>Leave the minimum threshold value set at zero and adjust the maximum threshold value to remove the background signal without influencing the true signal. Click on Apply.
		<ol>
			<li>Area measurement
			<ol>
				<li>Click on Analyze, choose Set Measurement. Select Area, Mean grey value, and Min and Max grey value and click on OK to confirm.</li>
				<li>Measure the size of the nucleus using the Analyze option, and then select Measure. 
				NOTE: The Results window gives the name of the image (Label), size of the image (Area), the average pixel intensity of the IHC image (Mean), and the minimum and maximum gray values (Min, Max). Use the Mean value for calculation.</li>
				<li>Repeat steps 4.2.6-4.7.1.2 for the Color 2 (and Color 3 if there is dual staining) window.</li>
			</ol>
			</li>
			<li>Cell quantification
			<ol>
				<li>Click on Process, choose the option Binary and select Watershed to separate cells.</li>
				<li>Go to Analyze and click on Analyze Particles. On the Analyze Particles pop-up window, set the size of the cells to exclude unspecific particles. Next, on the Show option, click on the drop-down box and select Outlines. Then, click on OK.</li>
				<li>Repeat steps 4.2.6-4.2.7 and cell quantification steps (section 4.2.7.2) for the Color 2 (and Color 3 if there is dual staining) window. 
				&#8203;NOTE: Now three windows will appear: 1) Summary results (number of cells counted, total area, average size, % of area and mean), 2) Results (respective to the cells that are counted), and 3) Drawing window (depicted image of the cells that are counted).</li>
			</ol>
			</li>
		</ol>
		</li>
	</ol>
	</li>
</ol>
5. Live/dead staining in Spheroids
<ol>
	<li>Prepare 4 mM stock solutions of Calcein AM in DMSO (stains live cells green) and 2 mM of Ethidium homodimer in DMSO (stains dead cells red) in 1.5 mL tubes.</li>
	<li>Calculate the amount of solution necessary to add 10 &#181;L/well of a mixture of Calcein AM and Ethidium homodimer diluted 1:50 in EBM-2.</li>
	<li>Add the staining mixture to the spheroids and place the plate in the incubator under standard tissue culture conditions for 30-60 min.</li>
	<li>Acquire pictures (40x) using the Fluorescence stereo microscope.</li>
</ol>
6. Spheroid&#39;s protein and RNA isolation
<ol>
	<li>Prepare cell suspensions at 3.4 x 105 cells/mL per cell type, mix them at a ratio of 1:1, and seed the cell mixture using a P20 pipette in the form of 15 &#181;L drops on the lid of a 10 cm Petri dish. Invert the lid and place it in the incubator under standard tissue culture conditions for 96 h.</li>
	<li>Use 5-6 mL of PBS to collect spheroids in a 15 mL round-bottom Polystyrene tube using 5 mL sterile polystyrene pipettes. 
	NOTE: It is also possible to use 15 mL conical tubes.</li>
	<li>Centrifuge the spheroids suspension at 250 x g&#160;for 5 min, and then carefully aspirate the supernatant.</li>
	<li>Add 500 &#181;L of trypsin (100%) and pipette up and down using a P1000 pipette for 30 s to disaggregate spheroids, achieving a cell suspension.</li>
	<li>Neutralize trypsin with 10% FCS medium, centrifuge the tubes at 250 x g for 5 min, and aspirate the supernatant.</li>
	<li>According to the manufacturer&#39;s protocol (specific kit for DNA-free RNA isolation), use 300 &#181;L of RNA lysis buffer to lyse the cell pellet. 
	NOTE: Lysis buffer can also be directly added to the intact spheroids (no trypsin step required) to extract RNA. Add 300 &#181;L of the lysis buffer to the pelleted spheroids, place tubes in ice, and triturate 10 times using a P200 pipette. Subsequently, isolate RNA as above. Spheroid dissociation may be needed if RNA recovery is low due to matrix interference.</li>
	<li>Alternatively, use 70 &#181;L of the Lysis buffer for protein isolation. Homogenize for 2-4 s by sonication and determine the protein concentration according to the manufacturer&#39;s protocol using a BCA Assay Kit. 
	NOTE: For protein isolation, pelleted spheroids can be lysed directly in lysis buffer followed by sonication. Use 25 &#181;g of total protein to perform western blot.</li>
</ol>

The authors have nothing to disclose.

Compared to 2D cell cultures, revolutionary 3D spheroid culture technology is a better and more powerful tool to reconstruct an organ&#39;s microenvironment, cell-cell interactions, and drug responses in vitro. This is the first protocol describing the formation of spheroids from multicellular (epithelial and endothelial) cell lines for breast cancer research. This protocol ensures spheroidal 3D growth of spheroids for up to 5 days, and spheroids can be examined after paraffin embedding, sectioning, and histolog...

The use of animals for experiments has limitations. Animal studies cannot accurately mimic disease progression in humans, and animals and humans do not have identical responses to pathogens. Additionally, restrictions in animal experimentation due to concerns for animal suffering and ethical problems1,2 increasingly constrain research programs. In vitro systems have been widely developed to circumvent the use of animals; moreover, the use of human cells has made in vitro models more relevant for the pathophysiological and therapeutic investigation. Conventional monolayer (2D) cell cultures are widely used because they mimic human tissues to some degree. However, 2D monocultures fail to mimic human organs, and 2D monocultures are unable to simulate the complex microenvironment of the original organs and mimic the in vivo situation3,4,5,6. Additionally, in monolayer cell cultures, drug treatments could easily destroy/damage all of the cells. Importantly, some of these limitations can be overcome by switching to multilayer three-dimensional (3D) cell cultures7,8. In fact, 3D culture models have been shown to better reflect the cellular structure, layout, and function of cells in primary tissues. These 3D cultures can be formed using a variety of cell lines, similar to a functional organ. Indeed, there are two models of 3D cultures. One model produces spheroids of aggregated cells that form clusters and reorganize them into spheres (scaffold-free models). The second yields organoids, which have a more complex structure and consist of combinations of multiple organ-specific cells, which are considered as a miniature version of organs9,10. Due to this, 3D culture systems represent an innovative technology with many biological and clinical applications. Thus, spheroids and organoids have numerous applications for disease modeling and studies related to regenerative medicine, drug screening, and toxicological studies6,11,12,13,14,15. Carcinogenic spheroids, derived from 3D technology, recreate the morphology and phenotype of relevant cell types, mimic the in vivo tumor microenvironment, and model cell communications and signaling pathways that are operational during tumor development16,17,18. In addition, to improve cancer biology understanding, tumor spheroids/organoids can also be used to identify a potential patient-specific anti-cancer therapy (personalized) and assess its efficacy, toxicity, and long-term effects19,20,21,22. Spheroids have opened prominent opportunities to investigate pathophysiology, disease modeling and drug screening because of their ability to preserve cellular and three-dimensional tissue architecture, the ability to mimic the in vivo situation, and the cell-cell interactions. However, one must also be aware of the limitations of this system, such as the lack of vascular/systemic component, functional immune or nervous system, and the system represents a reductionist approach as compared to animal models. Indeed, in contrast to animal models, 3D structures provide only an approximation of the biology within a human body. Understanding the limitations of the 3D method may help researchers to design more refined and valid processes for producing spheroids that better represent an organ at a larger scale23,24,25.
Cancer is the leading cause of death worldwide, and breast cancer is the most common cancer in women26,27,28. To mimic the complex microenvironment of breast cancer, breast cancer spheroids should be cultured using cells that play a prominent role in breast tumors, i.e., epithelial cells, endothelial cells, fibroblasts, and/or immune cells. Moreover, for a spheroid representing breast cancer, the expression of female hormone receptors (estrogen/progesterone receptors), ability to conserve the patient tumor histological status, and ability to mimic response to therapy should also be considered. Studies have shown that 3D co-culture systems have a cellular organization similar to that of the primary tissue in vivo, have the capability to react in real-time to stimuli, and have functional androgen receptors29,30,31,32. Hence, a similar approach could be useful to mimic a breast tumor in vitro. The purpose of the current protocol is to establish a new method of generating breast cancer spheroids. This method utilizes estrogen receptor-positive MCF-7 cells (an immortalized human cell line of epithelial cells) and vascular endothelial cells (HUVECs) or lymphatic endothelial cells (HMVEC-DNeo) to create a model that mimics or closely reflects the interactions between these cells within a tumor. Although MCF-7 (estrogen-responsive) and endothelial cells have been used to develop spheroids in the present study, other cells such as fibroblasts which represent ~80% of the breast tumor mass, could also be combined in the future to better represent and mimic breast tumor.
There are several methods to form spheroids, such as: 1) the hanging droplet method that employs gravity33,34; 2) the magnetic levitation method that uses magnetic nanoparticles exposed to an external magnet35, and 3) the spheroid microplate method that is performed by seeding cells on low-attachment plates36,37. On the basis of the existing methods, which use only one cell type, the present protocol has been optimized using epithelial and endothelial cells to better mimic the growth conditions of breast cancer tumors in vivo38,39,40,41. This method can be easily achieved in the laboratory at a low cost and with minimal equipment requirements. Based on the need/goals of the lab, different approaches were used to form spheroids and gain relevant cellular material from these spheroids. In this context, for DNA, RNA, or protein analysis, the 3D spheroids are produced by co-culturing endothelial and epithelial cells with the hanging drop method. However, for functional studies, for example, to monitor cell growth after short interfering (siRNA) transfection and/or hormone treatment, the spheroids are generated using U-bottom plates.
The purpose of this technical protocol is to provide a detailed step-by-step description for 1) forming breast cancer multicellular-type spheroids, 2) preparing samples for histological staining, and 3) collection of cells for extraction of RNA, DNA, and proteins. Both the inexpensive hanging drop method and the more expensive U-bottom plates are used to form spheroids. Here, a protocol for preparing (fixing) spheroids for sectioning and subsequent immunostaining with markers to assess cell proliferation, apoptosis, and distribution of epithelial and endothelial cells within a spheroid is provided. Additionally, this protocol shows a complete step-by-step analysis of histological data using ImageJ software. Interpretation of biological data varies depending on the type of experiment and the antibodies used. Sectioning of fixed spheroids and subsequent staining of the sections was performed by a routine pathology lab (Sophistolab: info@sophistolab.ch)

<table border="1" fo:keep-together.within-page="1" fo:keep-with-next.within-page="always">
	<tbody>
		<tr>
			<td>100 mm &#215; 20 mm tissue-culture treated culture dishes</td>
			<td>Corning</td>
			<td>CLS430167</td>
			<td></td>
		</tr>
		<tr>
			<td>149MULTI0C1</td>
			<td></td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>35 x 10 mm Tissue Culture Dish</td>
			<td>Falcon</td>
			<td>353001</td>
			<td></td>
		</tr>
		<tr>
			<td>5 mL Serological Pipet, Polystyrene, Individually Packed, Sterile</td>
			<td>Falcon</td>
			<td>357543</td>
			<td></td>
		</tr>
		<tr>
			<td>Adobe Photoshop</td>
			<td></td>
			<td></td>
			<td>Version: 13.0.1 (64-bit)</td>
		</tr>
		<tr>
			<td>Antibiotic Antimycotic Solution (100&#215;)</td>
			<td>Sigma-Aldrich</td>
			<td>A5955</td>
			<td></td>
		</tr>
		<tr>
			<td>Calcein-AM</td>
			<td>Sigma-Aldrich</td>
			<td>17783</td>
			<td></td>
		</tr>
		<tr>
			<td>CD31 (cluster of differentiation 31)</td>
			<td>Cell Marque</td>
			<td>131M-95</td>
			<td>monoclonal mouse ab clone JC70</td>
		</tr>
		<tr>
			<td>CellTracker Green CMFDA (5-chloromethylfluorescein diacetate)</td>
			<td>Invitrogen</td>
			<td>C7025</td>
			<td></td>
		</tr>
		<tr>
			<td>CK8/18 (cytokeratins 8 and 18)</td>
			<td>DBS</td>
			<td>Mob189-05</td>
			<td>monoclonal mouse ab, clone 5D3</td>
		</tr>
		<tr>
			<td>CKX41 Inverted Microscope</td>
			<td>Olympus Life Science</td>
			<td></td>
			<td>Olympus DP27 digital camera</td>
		</tr>
		<tr>
			<td>Cleaved Caspase 3</td>
			<td>Cell Signaling</td>
			<td>9661L</td>
			<td>polyclonal rabbit ab</td>
		</tr>
		<tr>
			<td>Collagen (rat tail)</td>
			<td>Roche</td>
			<td>11 179 179 001</td>
			<td></td>
		</tr>
		<tr>
			<td>Coulter ISOTON II Diluent</td>
			<td>Beckman Coulter</td>
			<td>844 80 11</td>
			<td>Diluent II</td>
		</tr>
		<tr>
			<td>Coulter Z1, Cell Counter</td>
			<td>Coulter Electronics, Luton, UK</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Dehydrated Culture Media: Noble Agar</td>
			<td>BD Difco</td>
			<td>BD 214220</td>
			<td></td>
		</tr>
		<tr>
			<td>Dimethyl sulfoxide (DMSO)</td>
			<td>Sigma-Aldrich</td>
			<td>D2650</td>
			<td></td>
		</tr>
		<tr>
			<td>Dulbecco&#8217;s Modified Eagle&#8217;s Medium/Nutrient Mixture F-12 Ham</td>
			<td>Sigma-Aldrich</td>
			<td>D6434</td>
			<td></td>
		</tr>
		<tr>
			<td>EBM-2 Endothelial Cell Growth Basal Medium-2</td>
			<td>Lonza</td>
			<td>190860</td>
			<td></td>
		</tr>
		<tr>
			<td>Ethidium homodimer</td>
			<td>Sigma-Aldrich</td>
			<td>46043</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal Calf Serum (FCS)</td>
			<td>Thermo Fisher Scientific</td>
			<td>SH30070</td>
			<td></td>
		</tr>
		<tr>
			<td>Fetal Calf Serum Charcoal Stripped (FCS sf)</td>
			<td>Thermo Fisher Scientific</td>
			<td>SH3006803</td>
			<td></td>
		</tr>
		<tr>
			<td>Fluorescence stereo microscopes Leica M205 FA</td>
			<td>Leica Microsystems</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>GlutaMAX Supplement (100x)</td>
			<td>Gibco</td>
			<td>35050038</td>
			<td></td>
		</tr>
		<tr>
			<td>HBSS, no calcium, no magnesium, no phenol red</td>
			<td>Gibco</td>
			<td>14175053</td>
			<td></td>
		</tr>
		<tr>
			<td>Hoechst 33342</td>
			<td>Life Technologies</td>
			<td>H3570</td>
			<td></td>
		</tr>
		<tr>
			<td>HUVEC &#8211; Human Umbilical Vein Endothelial Cells</td>
			<td>Lonza</td>
			<td>CC-2517</td>
			<td></td>
		</tr>
		<tr>
			<td>ImageJ</td>
			<td>National Institute of Health, USA</td>
			<td></td>
			<td>Wayne Rasband 
			Version: 1.52a (64-bit)</td>
		</tr>
		<tr>
			<td>Ki67</td>
			<td>Cell Marque</td>
			<td>275R-16</td>
			<td>monoclonal rabbit ab, clone SP6</td>
		</tr>
		<tr>
			<td>Leica Histocore Multicut Rotary Microtome</td>
			<td></td>
			<td>149MULTI0C1</td>
			<td></td>
		</tr>
		<tr>
			<td>Low Serum Growth Supplement Kit (LSGS Kit)</td>
			<td>Gibco</td>
			<td>S003K</td>
			<td></td>
		</tr>
		<tr>
			<td>MCF-7 cells &#8211; human breast adenocarcinoma cell line</td>
			<td>Clinic for Gynecology, University Hospital Zurich</td>
			<td></td>
			<td>Provived from Dr Andr&#232; Fedier obtained from ATCC</td>
		</tr>
		<tr>
			<td>Nunclon Sphera 96U-well plate</td>
			<td>Thermo Fisher Scientific</td>
			<td>174925</td>
			<td></td>
		</tr>
		<tr>
			<td>Paraformaldehyde (PFA)</td>
			<td>Sigma-Aldrich</td>
			<td>P6148</td>
			<td></td>
		</tr>
		<tr>
			<td>Phosphate-buffered saline (PBS) 1x</td>
			<td>Gibco</td>
			<td>10010015</td>
			<td></td>
		</tr>
		<tr>
			<td>Pierce BCA Protein Assay Kit</td>
			<td>Thermo Scientific</td>
			<td>23225</td>
			<td></td>
		</tr>
		<tr>
			<td>Protein Lysis Buffer</td>
			<td>Cell Signaling, Danvers, USA</td>
			<td>9803</td>
			<td></td>
		</tr>
		<tr>
			<td>Quick-RNA Miniprep Kit</td>
			<td>Zymo Research</td>
			<td>R1055</td>
			<td></td>
		</tr>
		<tr>
			<td>RNA Lysis Buffer</td>
			<td>Zymo Research</td>
			<td>R1060-1-100</td>
			<td>Contents in Quick-RNA Miniprep Kit</td>
		</tr>
		<tr>
			<td>Rotina 46R Centrifuge</td>
			<td>Hettich</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Round-Bottom Polystyrene Tubes, 5 mL</td>
			<td>Falcon</td>
			<td>352003</td>
			<td></td>
		</tr>
		<tr>
			<td>Sonicator</td>
			<td>Bandelin electronics, Berlin, DE</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Tecan Infinite series M200 microplate reader</td>
			<td>Tecan, Salzburg, AU</td>
			<td></td>
			<td></td>
		</tr>
		<tr>
			<td>Tissue Culture Flasks 75</td>
			<td>TPP</td>
			<td>90076</td>
			<td></td>
		</tr>
		<tr>
			<td>Trypsin-EDTA solution</td>
			<td>Sigma-Aldrich</td>
			<td>T3924</td>
			<td></td>
		</tr>
	</tbody>
</table>

mammary epithelial and endothelial cell spheroids as a potential functional in vitro model for breast cancer research

Breast cancer is the leading cause of mortality in women. The growth of breast cancer cells and their subsequent metastasis is a key factor for its progression. Although the mechanisms involved in promoting breast cancer growth have been intensively studied using monocultures of breast cancer cells such as MCF-7 cells, the contribution of other cell types, such as vascular and lymphatic endothelial cells that are intimately involved in tumor growth, has not been investigated in depth. Cell-cell interaction plays a key role in tumor growth and progression. Neoangiogenesis, or the development of vessels, is essential for tumor growth, whereas the lymphatic system serves as a portal for cancer cell migration and subsequent metastasis. Recent studies provide evidence that vascular and lymphatic endothelial cells can significantly influence cancer cell growth. These observations imply a need for developing in vitro models that would more realistically reflect breast cancer growth processes in vivo. Moreover, restrictions in animal research require the development of ex vivo models to elucidate better the mechanisms involved.
This article describes the development of breast cancer spheroids composed of both breast cancer cells (estrogen receptor-positive MCF-7 cells) and vascular and/or lymphatic endothelial cells. The protocol describes a detailed step-by-step approach in creating dual-cell spheroids using two different approaches, hanging drop (gold standard and cheap) and 96-well U-bottom plates (expensive). In-depth instructions are provided for how to delicately pick up the formed spheroids to monitor growth by microscopic sizing and assessing viability using dead and live cell staining. Moreover, procedures to fix the spheroids for sectioning and staining with growth-specific antibodies to differentiate growth patterns in spheroids are delineated. Additionally, details for preparing spheroids with transfected cells and methods to extract RNA for molecular analysis are provided. In conclusion, this article provides in-depth instructions for preparing multi-cell spheroids for breast cancer research.

The spheroids model using epithelial and endothelial co-cultures is required to closely mimic in vivo conditions of breast tumors for in vitro experiments. The scheme in Figure 1 depicts the protocol to form spheroids with breast cancer epithelial cells and vascular or lymphatic endothelial cells (Figure 1). Each cell type is seeded separately in a 3.5 cm round dish and treated with growth stimulators/inhibitors or transfected with oligonucleot...

Watch this Scientific Journal Video about Mammary Epithelial and Endothelial Cell Spheroids as a Potential Functional In vitro Model for Breast Cancer Research at JoVE.com

Mammary Epithelial and Endothelial Cell Spheroids as a Potential Functional In vitro Model for Breast Cancer Research

Crosstalk between mammary epithelial cells and endothelial cells importantly contributes to breast cancer progression, tumor growth, and metastasis. In this study, spheroids have been made from breast cancer cells together with vascular and/or lymphatic endothelial cells and demonstrate their applicability as an in vitro system for breast cancer research.

Mammary Epithelial and Endothelial Cell Spheroids as a Potential Functional In vitro Model for Breast Cancer Research

Breast cancer is the leading cause of mortality in women. The growth of breast cancer cells and their subsequent metastasis is a key factor for its ...

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Research

JoVE Journal

Cancer Research

4.3K Views.  University of Zurich and University Hospital Zurich. Crosstalk between mammary epithelial cells and endothelial cells importantly contributes to breast cancer progression, tumor growth, and metastasis. In this study, spheroids have been made from breast cancer cells together with vascular and/or lymphatic endothelial cells and demonstrate their applicability as an in vitro system for breast cancer research.

Video: Mammary Epithelial and Endothelial Cell Spheroids as a Potential Functional In vitro Model for Breast Cancer Research

Utilizing Functional Genomics Screening to Identify Potentially Novel Drug Targets in Cancer Cell Spheroid Cultures

The identification of functional driver events in cancer is central to furthering our understanding of cancer biology and indispensable for the discovery of the next generation of novel drug targets. It is becoming apparent that more complex models of cancer are required to fully appreciate the contributing factors that drive tumorigenesis in vivo and increase the efficacy of novel therapies that make the transition from pre-clinical models to clinical trials.
Here we present a methodology for generating uniform and reproducible tumor spheroids that can be subjected to siRNA functional screening. These spheroids display many characteristics that are found in solid tumors that are not present in traditional two-dimension culture. We show that several commonly used breast cancer cell lines are amenable to this protocol. Furthermore, we provide proof-of-principle data utilizing the breast cancer cell line BT474, confirming their dependency on amplification of the epidermal growth factor receptor HER2 and mutation of phosphatidylinositol-4,5-biphosphate 3-kinase (PIK3CA) when grown as tumor spheroids. Finally, we are able to further investigate and confirm the spatial impact of these dependencies using immunohistochemistry.

Identifying novel drug targets that transition from pre-clinical testing to human trials is a scientific priority. To that end, here we describe a functional genomics approach for examining the impact of gene depletion on cancer cell line spheroids, which more appropriately model human cancers in vivo.

The identification of functional driver events in cancer is central to furthering our understanding of cancer biology and indispensable for the discovery ...

Surgical Procedures and Methodology for a Preclinical Murine Model of De Novo Mammary Cancer Metastasis

A rate-limiting aspect of transgenic mouse models of mammary adenocarcinoma is that primary tumor burden in mammary tissue typically defines study end-points. Thus, studies focused on elucidating mechanisms of late-stage de novo metastasis are compromised, as are studies examining efficacy of anti-cancer therapies targeting mediators of metastasis in the adjuvant setting. Numerous murine mammary cancer models have been developed via targeted expression of dominant oncoproteins to mammary epithelial cells yielding models variably mimicking histopathologic and transcriptome-defined breast cancer subtypes common in women1. While much has been learned regarding the biology of mammary carcinogenesis with these models, their utility in identifying molecules regulating growth of late-stage metastasis are compromised as mice are typically euthanized at earlier time points due to significant primary tumor burden. Moreover, since a significant percentage of women diagnosed with breast cancer receive adjuvant therapy after surgical resection of primary tumors and prior to presence of detectable metastatic disease, preclinical models of de novo metastasis are urgently needed as platforms to evaluate new therapies aimed at targeting metastatic foci. To address these deficiencies, we developed a murine model of de novo mammary cancer metastasis, wherein primary mammary tumors are surgically resected, and metastatic foci subsequently develop over a 115 day post-surgical period. This long latency provides a tractable model to identify functionally significant regulators of metastatic progression in mice lacking primary tumor, as well as a model to evaluate preclinical therapeutic efficacy of agents aimed at blocking functionally significant molecules aiding metastatic tumor survival and growth.

Surgical Procedures and Methodology for a Preclinical Murine Model of De Novo Mammary Cancer Metastasis

Pre-clinical models evaluating adjuvant therapy targeting breast cancer metastasis are lacking. To address this, we developed a murine model of de novo pulmonary mammary adenocarcinoma metastasis, wherein therapies administered in the adjuvant setting (post surgical resection of primary tumors) can be evaluated for efficacy in impacting previously seeded pulmonary metastases.

A rate-limiting aspect of transgenic mouse models of mammary adenocarcinoma is that primary tumor burden in mammary tissue typically defines study ...

A Portal Vein Injection Model to Study Liver Metastasis of Breast Cancer

Breast cancer is the leading cause of cancer-related mortality in women worldwide. Liver metastasis is involved in upwards of 30% of cases with breast cancer metastasis, and results in poor outcomes with median survival rates of only 4.8 - 15 months. Current rodent models of breast cancer metastasis, including primary tumor cell xenograft and spontaneous tumor models, rarely metastasize to the liver. Intracardiac and intrasplenic injection models do result in liver metastases, however these models can be confounded by concomitant secondary-site metastasis, or by compromised immunity due to removal of the spleen to avoid tumor growth at the injection site. To address the need for improved liver metastasis models, a murine portal vein injection method that delivers tumor cells firstly and directly to the liver was developed. This model delivers tumor cells to the liver without complications of concurrent metastases in other organs or removal of the spleen. The optimized portal vein protocol employs small injection volumes of 5 - 10 &#956;l, &#8805; 32 gauge needles, and hemostatic gauze at the injection site to control for blood loss. The portal vein injection approach in Balb/c female mice using three syngeneic mammary tumor lines of varying metastatic potential was tested; high-metastatic 4T1 cells, moderate-metastatic D2A1 cells, and low-metastatic D2.OR cells. Concentrations of &#8804; 10,000 cells/injection results in a latency of ~ 20 - 40 days for development of liver metastases with the higher metastatic 4T1 and D2A1 lines, and &#62; 55 days for the less aggressive D2.OR line. This model represents an important tool to study breast cancer metastasis to the liver, and may be applicable to other cancers that frequently metastasize to the liver including colorectal and pancreatic adenocarcinomas.

A surgical procedure was developed to deliver mammary tumor cells to the murine liver via portal vein injection. This model permits investigation of late stages of liver metastasis in a fully immune competent host, including tumor cell extravasation, seeding, survival, and metastatic outgrowth in the liver.

Breast cancer is the leading cause of cancer-related mortality in women worldwide. Liver metastasis is involved in upwards of 30% of cases with breast ...

Sectioning Mammary Gland Whole Mounts for Lesion Identification

Normal mammary gland development may be altered by exposure to environmental toxicants and pharmaceutical products, excessive exposure to hormones, and genetic alterations. Mammary gland whole mounts are an inexpensive method to capture the progression of morphological changes that may arise after exposure. However, in later life, when abnormalities are more prone to develop, sole reliance on this one method may not always provide enough information to make a proper diagnosis of the abnormality. Historically, in chemical test guideline studies, a single mammary gland is removed at necropsy and prepared as a hematoxylin and eosin (H&#38;E)-stained section. The incorporation of contralateral mammary whole-mount collection and analysis decreases the likelihood of a false-negative assessment. Evaluation of the whole mount is limited by the presence of one or two entire mammary glands on a slide, and in some cases, the abnormalities observed in the whole mount are not uniformly represented in the H&#38;E section.&#160; The goal of this study was to develop a protocol for converting coverslipped mammary whole mounts to H&#38;E-stained sections so that lesions that would otherwise have been missed or that are difficult to diagnose can be identified. Here, we detail a method to produce a high-quality, paraffin-embedded H&#38;E section from a mammary gland that was initially prepared as a whole mount. In comparison to a tissue that was intentionally prepared for H&#38;E sectioning, the whole mount requires additional preparation for tissue removal and processing. However, this method is considered inexpensive, as it requires common lab reagents and little additional time. As a result, this method can provide invaluable information on how chemical and environmental exposures alter normal mammary development, as well as display changes that occur because of genetic modifications.

We developed a method to successfully remove, process, section, and stain, for histopathological evaluation, mammary tissue that had originally been fixed on slides as whole mounts. This method may promote the collection and evaluation of mammary gland whole mounts in reproductive and developmental test guideline studies.

Normal mammary gland development may be altered by exposure to environmental toxicants and pharmaceutical products, excessive exposure to hormones, and ...

Obtaining Cancer Stem Cell Spheres from Gynecological and Breast Cancer Tumors

Cancer stem cells (CSC) are a small population with self-renewal and plasticity which are responsible for tumorigenesis, resistance to treatment and recurrent disease. This population can be identified by surface markers, enzymatic activity and a functional profile. These approaches per se are limited, due to phenotypic heterogeneity and CSC plasticity. Here, we update the sphere-forming protocol to obtain CSC spheres from breast and gynecological cancers, assessing functional properties, CSC markers and protein expression. The spheres are obtained with single-cell seeding at low density in suspension culture, using a semi-solid methylcellulose medium to avoid migration and aggregates. This profitable protocol can be used in cancer cell lines but also in primary tumors. The tridimensional non-adherent suspension culture thought to mimic the tumor microenvironment, particularly the CSC-niche, is supplemented with epidermal growth factor and basic fibroblast growth factor to ensure CSC signaling. Aiming for robust identification of CSC, we propose a complementary approach, combining functional and phenotypic evaluation. Sphere-forming capacity, self-renewal and sphere projection area establish CSC functional properties. Additionally, characterization comprises flow cytometry evaluation of the markers, represented by CD44+/CD24- and CD133, and Western blot, considering ALDH. The presented protocol was also optimized for primary tumor samples, following a sample digestion procedure, useful for translational research.

The aim of this methodology is to identify cancer stem cells (CSC) in cancer cell lines and primary human tumor samples with the sphere-forming protocol, in a robust manner, using functional assays and phenotypic characterization with flow cytometry and Western blot.

Cancer stem cells (CSC) are a small population with self-renewal and plasticity which are responsible for tumorigenesis, resistance to treatment and ...

A 3D Spheroid Model as a More Physiological System for Cancer-Associated Fibroblasts Differentiation and Invasion In Vitro Studies

Defining the ideal model for an in vitro study is essential, mainly if studying physiological processes such as differentiation of cells. In the tumor stroma, host fibroblasts are stimulated by cancer cells to differentiate. Thus, they acquire a phenotype that contributes to the tumor microenvironment and supports tumor progression. By using the spheroid model, we have set up such a 3D in vitro model system, in which we analyzed the role of laminin-332 and its receptor integrin &#945;3&#946;1 in this differentiation process. This spheroid model system not only reproduces the tumor microenvironment conditions in a more accurate way, but also is a very versatile model since it allows different downstream studies, such as immunofluorescent staining of both intra- and extracellular markers, as well as deposited extracellular matrix proteins. Moreover, transcriptional analyses by qPCR, flow cytometry and cellular invasion can be studied with this model. Here, we describe a protocol of a spheroid model to assess the role of CAFs&#39; integrin &#945;3&#946;1 and its ectopically deposited ligand, laminin-332, in differentiation and in supporting the invasion of pancreatic cancer cells.

The goal of this protocol is to establish a 3D in vitro model to study the differentiation of cancer-associated fibroblasts (CAFs) in a tumor bulk-like environment, which can be addressed in different analysis systems, such as immunofluorescence, transcriptional analysis and life cell imaging.

Defining the ideal model for an in vitro study is essential, mainly if studying physiological processes such as differentiation of cells. In the tumor ...

Studying Triple Negative Breast Cancer Using Orthotopic Breast Cancer Model

Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype with limited therapeutic options. When compared to patients with less aggressive breast tumors, the 5-year survival rate of TNBC patients is 77% due to their characteristic drug-resistant phenotype and metastatic burden. Toward this end, murine models have been established aimed at identifying novel therapeutic strategies limiting TNBC tumor growth and metastatic spread. This work describes a practical guide for the TNBC orthotopic model where MDA-MB-231 breast cancer cells suspended in a basement membrane matrix are implanted in the fourth mammary fat pad, which closely mimics the cancer cell behavior in humans. Measurement of tumors by caliper, lung metastasis assessment via in vivo and ex vivo imaging, and molecular detection are discussed. This model provides an excellent platform to study therapeutic efficacy and is especially suitable for the study of the interaction between the primary tumor and distal metastatic sites.

This work presets an advanced protocol to accurately assess tumor loading by detection of green fluorescent protein and bioluminescence signals as well as the integration of quantitative molecular detection technique.

Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype with limited therapeutic options. When compared to patients with less ...

Rat Mammary Epithelial Cell Transplantation into the Interscapular White Fat Pad

As early as the 1970s, researchers have successfully transplanted mammary epithelial cells into the interscapular white fat pad of rats. Grafting mammary epithelium using transplantation techniques takes advantage of the hormonal environment provided by the adolescent rodent host. These studies are ideally suited to explore the impact of various biological manipulations on mammary gland development and dissect many aspects of mammary gland biology. A common, but limiting, feature is that transplanted epithelial cells are strongly influenced by the surrounding stroma and outcompeted by endogenous epithelium; to utilize native mammary tissue, the abdominal-inguinal white fat pad must be cleared to remove host mammary epithelium prior to the transplantation. A major obstacle when using the rat model organism is that clearing the developing mammary tree in post-weaned rats is not efficient. When transplanted into gland-free fat pads, donor epithelial cells can repopulate the cleared host fat pad and form a functional mammary gland. The interscapular fat pad is an alternative location for these grafts. A major advantage is that it lacks ductal structures yet provides the normal stroma that is necessary to promote epithelial outgrowth and is easily accessible in the rat. Another major advantage of this technique is that it is minimally invasive, because it eliminates the need to cauterize and remove the growing endogenous mammary tree. Additionally, the interscapular fat pad contains a medial blood vessel that can be used to separate sites for grafting. Because the endogenous glands remain intact, this technique can also be used for studies comparing the endogenous mammary gland to the transplanted gland. This paper describes the method of mammary epithelial cell transplantation into the interscapular white fat pad of rats.

This article describes a transplantation method to graft donor rat mammary epithelial cells into the interscapular white fat pad of recipient animals. This method can be used to examine host and/or donor effects on mammary epithelium development and eliminates the need for pre-clearing, thereby extending the usefulness of this technique.

As early as the 1970s, researchers have successfully transplanted mammary epithelial cells into the interscapular white fat pad of rats. Grafting mammary ...

Orthotopic Transplantation of Breast Tumors as Preclinical Models for Breast Cancer

Preclinical models that faithfully recapitulate tumor heterogeneity and therapeutic response are critical for translational breast cancer research. Immortalized cell lines are easy to grow and genetically modify to study molecular mechanisms, yet the selective pressure from cell culture often leads to genetic and epigenetic alterations over time. Patient-derived xenograft (PDX) models faithfully recapitulate the heterogeneity and drug response of human breast tumors. PDX models exhibit a relatively short latency after orthotopic transplantation that facilitates the investigation of breast tumor biology and drug response. The transplantable genetically engineered mouse models allow the study of breast tumor immunity. The current protocol describes the method to orthotopically transplant breast tumor fragments into the mammary fat pad followed by drug treatments. These preclinical models provide valuable approaches to investigate breast tumor biology, drug response, biomarker discovery and mechanisms of drug resistance.

Patient-derived xenograft (PDX) models and transplantable genetically engineered mouse models faithfully recapitulate human disease and are preferred models for basic and translational breast cancer research. Here, a method is described to orthotopically transplant breast tumor fragments into the mammary fat pad to study tumor biology and evaluate drug response.

Preclinical models that faithfully recapitulate tumor heterogeneity and therapeutic response are critical for translational breast cancer research. ...

In Vitro Evaluation of Oncogenic Transformation in Human Mammary Epithelial Cells

Tumorigenesis is a multi-step process in which cells acquire capabilities&#160;that allow their growth, survival, and dissemination under hostile conditions. Different tests seek to identify and quantify these hallmarks of cancerous cells; however, they often focus on a single aspect of cellular transformation and, in fact, multiple tests are required for their proper characterization. The purpose of this work is to provide researchers with a set of tools to assess cellular transformation in vitro from a broad perspective, thereby making it possible to draw sound conclusions.
A sustained proliferative signaling activation is the major feature of tumoral tissues and can be easily monitored under in vitro conditions by calculating the number of population doublings achieved over time. Besides, the growth of cells in 3D cultures allows their interaction with surrounding cells, resembling what occurs in vivo. This enables the evaluation of cellular aggregation and, together with immunofluorescent labeling of distinctive cellular markers, to obtain information on another relevant feature of tumoral transformation: the loss of proper organization. Another remarkable characteristic of transformed cells is their capacity to grow without attachment to other cells and to the extracellular matrix, which can be evaluated with the anchorage assay.
Detailed experimental procedures to evaluate cell growth rate, to perform immunofluorescent labeling of cell lineage markers in 3D cultures, and to test anchorage-independent cell growth in soft agar are provided. These methodologies are optimized for Breast Primary Epithelial Cells (BPEC) due to its relevance in breast cancer; however, procedures can be applied to other cell types after some adjustments.

This protocol provides experimental in vitro tools to evaluate the transformation of human mammary cells. Detailed steps to follow-up cell proliferation rate, anchorage-independent growth capacity, and distribution of cell lineages in 3D cultures with basement membrane matrix are described.