The Princess Margaret Hospital Breast Site Group expressed the need for a comprehensive clinical database for breast disease to increase access to detailed high-quality clinical data for research and administrative purposes. The database sought to capture patient history, diagnosis, treatment and follow-up information for over 1,200 new breast disease patients per year. The extensiveness of this information combined with the size of the patient cohort made this a challenging project. The project began with a simple database tool that was flexible and adaptable so that it could be customized to suit the needs of the clinicians in the Breast Site Group. Since the early simplistic implementation, novel data collection techniques have been added to the improve quality and completeness of data. This approach facilitated increased confidence in the project on the part of clinicians, which allowed for more constructive input from all parties, and has resulted in a tool that is useful and relevant to members of the Breast Site Group. The success of this project lies in its initial simplicity and gradual development in stages, allowing continual improvement and constant collaboration between all those involved.