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Bring a large pot of heavily salted water to a boil. Add orecchiette and cook until al dente.
While pasta cooks, heat a large skillet over medium. Add sausage and brown, breaking into small crumbles. Cook until fully browned. Drain off most of the fat, leaving about 1 tablespoon in the pan.
Add minced shallot to the sausage and sauté 1–2 minutes until soft and fragrant. Add red pepper flakes and a few cracks of black pepper.
During the last 1½ minutes of pasta cooking, add broccoli florets directly to the pasta water to blanch. Before draining, reserve ¾ cup pasta water. Drain pasta and broccoli together.
Add pasta and broccoli to the skillet with sausage. Toss over medium heat. Add lemon juice and ½ cup reserved pasta water. Stir and toss until glossy and emulsified, adding more pasta water as needed to create a light sauce.
Season generously with salt and pepper. Serve immediately with grated Parmesan if desired.