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Cook orecchiette according to package directions
Brown Italian sausage in a large pan, breaking it into crumbles as it cooks, then remove and set aside
In the same pan, heat olive oil and sauté sliced garlic and red pepper flakes until fragrant
Add anchovy fillets or paste if using, and stir to combine
Add chopped broccoli rabe and cook until tender
Deglaze pan with dry white wine if using
Return sausage to the pan and toss with broccoli rabe
Combine cooked orecchiette with the sausage and broccoli rabe mixture
Toss with remaining olive oil, lemon zest, and lemon juice if desired
Top with Parmigiano Reggiano if using
Season with salt and freshly cracked black pepper to taste