Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is hyperexpansion of the lungs , with flattening of both hemidiaphragms , compatible with COPD . Right upper lobe scarring and pleural thickening is likely unchanged compared to the prior study , given differences in patient positioning . There is no overt pulmonary edema , pneumothorax , or focal consolidation worrisome for pneumonia . There is likely a small left pleural effusion and / or pleural thickening at the left lung base . Irregular calcification in the right lateral breast is better assessed on prior mammogram . Right proximal humeral fracture is again noted . No displaced rib fractures are identified .
    OUTPUT:
    
No evidence of pneumonia . Findings compatible with COPD . Right proximal humeral fracture is better characterized on separately dictated shoulder radiographs . No displaced rib fractures seen .