Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual - chamber pacemaker device is re - demonstrated with leads terminating in the right atrium and right ventricle . Heart size is mildly enlarged . The aortic knob is calcified . Mediastinal and hilar contours are unchanged . Focal aneurysm of the descending thoracic aorta is again noted , and better assessed on the previous CT . Previously noted left pleural effusion has substantially decreased in size while the right pleural effusion also appears minimal . Pulmonary vasculature is normal . No focal consolidation or pneumothorax is present . The lungs are hyperinflated . Patient is status post bilateral mastectomies with clips demonstrated overlying the chest wall bilaterally . Multiple clips are also noted in the right upper quadrant of the abdomen . Known diffuse osseous metastatic lesions are better appreciated on the previous CT .
    OUTPUT:
    
Decreased size of left pleural effusion , now minimal , and continued small right pleural effusion . Re - demonstration of diffuse osseous metastases .