Surgical audit is routinely conducted throughout the surgical community in order to examine practice in a peer-review environment. A national audit for breast cancer surgery has been implemented in Australia and New Zealand. It aims to standardize the way in which surgical activities are recorded. The present paper describes the development and implementation of the audit project. An audit kit including instruction manual, data dictionary and choice of two data collection instruments (paper or database) were distributed among participants. Surgeons record their patients prospectively, submit data to central office and provide feedback. Information on 3000 breast cancer patients has been collected within the first 6 months. The project has been successfully implemented and is continuing to develop. Many surgeons have incorporated the patient record forms in their routine case management activities. Comments and other submissions have been reviewed and changes incorporated into the second and subsequent releases of the kit.