Newswise — Even after successful breast cancer surgery and radiation, there's a chance that some cancer cells remain. To reduce the risk of recurrence, many women opt for adjuvant therapy, additional treatment when there are no visible signs of cancer.

The May issue of Mayo Clinic Health Letter covers the choices. Adjuvant therapy options include chemotherapy, hormonal therapy (tamoxifen or aromatase inhibitors) or a combination of the two. Studies have shown that combination therapy may increase disease-free-survival rate by as much as 17 percent. Women and their care providers need to weigh several factors to determine the best treatment.

Considerations include:

Tumor size: Women with small tumors usually have better outcomes than women with large tumors.

Lymph node status: If lymph nodes contain cancer cells, more aggressive therapy may be recommended.

Hormone receptor status: Hormone therapy is only an option if the cancer cells are able to take in hormones. Some breast cancers don't.

Age: Women 70 and older may have less aggressive cancers. Premenopausal women often respond better to chemotherapy. After menopause, women are more likely to have hormone-receptive positive cancer cells and respond well to hormone therapy alone.

Although most women with invasive breast cancer are urged to consider adjuvant therapy, it does have some risks and side effects. Some women choose watchful waiting instead with regular mammograms and follow-up exams.

Mayo Clinic Health Letter is an eight-page monthly newsletter of reliable, accurate and practical information on today's health and medical news. To subscribe, please call toll free 800-333-9037, extension 9PR1.

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