Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The lungs are well - expanded . Extensive interstitial changes are noted , similar prior exam . There is no pleural effusion or pneumothorax . The cardiomediastinal silhouette is unremarkable . The patient is status post mastectomy .
    OUTPUT:
    
Extensive interstitial changes , similar to prior exam , and status post mastectomy . Lung changes may represent chronic pulmonary disease , however in light of the mastectomy possible lymphangitic metastases would also have to be considered . Chest CT is recommended for further evaluation .