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Updated: May 9, 2026
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Published on: November 1, 2024
Endometrial echo complex thickness in postmenopausal endometrial cancer.
Uma Chandavarkar1, Julie M Kuperman, Laila I Muderspach
1Division of Gynecologic Oncology, Los Angeles County-University of Southern California Medical Center, Los Angeles, CA, USA; Division of Gynecologic Oncology, MultiCare Regional Cancer Center, Tacoma, WA, USA.
A significant portion of postmenopausal women with endometrial cancer (EC) show a normal endometrial echo complex (EEC) thickness of 4 mm or less. This finding suggests that an EEC of 4 mm or less does not rule out EC and requires histological confirmation.
Area of Science:
- Gynecology
- Oncology
- Radiology
Background:
- Endometrial cancer (EC) is a common gynecologic malignancy.
- Postmenopausal bleeding is a key symptom requiring investigation.
- Endometrial echo complex (EEC) thickness on ultrasound is used to evaluate the endometrium.
Purpose of the Study:
- To characterize preoperative pelvic ultrasonographic findings in postmenopausal women with endometrial cancer.
- To correlate endometrial echo complex (EEC) thickness with EC subtypes.
Main Methods:
- Retrospective review of 250 postmenopausal women with EC.
- Analysis of transvaginal pelvic ultrasound reports for EEC thickness.
- Comparison of EEC thickness between type 1 and type 2 EC using statistical tests.
Main Results:
- 36% of patients with EC had an EEC of 4 mm or less.
- No significant difference in EEC thickness between type 1 (37%) and type 2 (34%) EC.
- No demographic differences between EC types, except for postmenopausal bleeding.
Conclusions:
- An endometrial echo complex (EEC) of 4 mm or less does not exclude endometrial cancer.
- Histologic evaluation remains crucial for diagnosing EC, even with a thin EEC.
- Current guidelines recommending no further procedures for EEC ≤ 4 mm may need reconsideration.
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