There is new elevation of the left hemidiaphragm since the previous CXR 3 months earlier. This is associated with mild passive atelectasis in the left base and a small left pleural effusion. The remainder of the left lung is clear, as is the right lung. No right pleural effusion. The left hilum appears stable when compared to the previous chest x-ray. Left mastectomy noted. No destructive osseous lesion appreciated. Cholecystectomy clips.
New elevation of the left hemidiaphragm, in this clinical setting (previous breast cancer) this requires further evaluation with CT chest to exclude malignant paralysis of the left phrenic nerve.