Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Frontal and lateral radiographs of the chest when compared to the prior study demonstrates increased lung volumes with hyperinflation , flattening of the diaphragms , and increased AP diameter , consistent with emphysematous change . Moderate left pleural effusion is relatively unchanged . The cardiac and mediastinal contours are normal . Surgical clips are again noted in the left axilla , likely from breast surgery . Left apicolateral lung fibrosis is seen , likely post-radiation changes . Calcified aortic knob is again seen .
    OUTPUT:
    
Interval increase in lung volumes with minimal change in moderate left pleural effusion .