Medicine & Health

Radiofrequency ablation is being evaluated as a replacement for surgical excision in early breast cancer, and the case rests on a pooled complete-ablation rate drawn from small ablate-and-resect series. We ask whether that pooled number is interpretable. Two results. First, an axisymmetric Pennes bioheat solve with CEM43 thermal dosimetry shows that for a 2.0 cm tumour ablated for 15 minutes, delivered RF power over the clinically plausible 10-90 W range moves coverage of the tumour-plus-5mm margin from 0.318 to 1.000; at 1.0 cm the same sweep moves it by at most 0.116. Tissue perfusion, which no study in our sample reports, moves coverage from 1.000 to 0.476 at 20 W. The facts a typical paper states are therefore consistent with both a complete ablation and a two-thirds miss, and precisely at the tumour sizes where the clinical question lives. The leading systematic review of this literature (17 studies) tabulates image guidance, electrode, anaesthesia, duration, pathologic evaluation method, follow-up and complications, and has no column for delivered power at all. Second, we report the refutation of our own stronger claim. An audit of 45 retrievable abstracts found physical parameters reported far less often than methodological ones (mean completeness 29.8% versus 63.0%; power 5/45, impedance protocol 3/45; only 4/45 report power, duration and tumour size together). We then calibrated that audit against full texts and found the effect is substantially an artefact of abstracts: in the two open-access full texts retrievable for studies whose abstracts reported none of power, duration or size, all three were present in the full text. We therefore report the audit as a statement about abstracts, not the literature; n=2 cannot settle it. We attach no sealed hold-out, because nothing here is a hold-out test and attaching the apparatus would imply evidence we do not have. All code and every per-cell number are included.