Longo Borghini attacked with van der Breggen on the steep slopes of the final climb, and the two held a sizable advantage when the climb flattened out 2km from the line before it steepened again for the final kilometre.
On the uphill finish, Longo Borghini beat Van der Breggen to the line in a tight dash to the line. The Dutch champion gained enough time on overnight race leader Katarzyna Niewiadoma (Canyon-SRAM) to take over the pink jersey with only one stage to come.
The win was Longo Borghini's first individual victory in her home race, after tasting team victory earlier this week as part of the winning Trek-Segafredo team time trial squad.
"I've been waiting many years for this victory, my first at the Giro Rosa, and I've tried many times this week," Longo Borghini said at the finish. "I want to thank my team, Trek-Segafredo, that set me up so well."
Van der Breggen said that it was far from her ideal scenario in taking the race lead after van Vleuten's crash, but noted how the absence of the rider with a stranglehold on the general classification had opened up the racing.
"This is not how you hope to get the pink and I hope everyone who was in the crash yesterday will be fine," van der Breggen said. "But you could feel that the fighting spirit was back in the race, today, and that was a good thing. Today was a hard stage, echelons, long downhills and the final climb was really steep and really long.
"I'm happy to be in pink."
After a short climb to begin the 91.5-kilometre stage from Castelnuovo della Daunia to San Marco la Catola, the first part of the stage was largely downhill, leading to high speeds. A combination of hard riding and strong crosswinds split the peloton into three groups.
White jersey and fourth overall at stage start, New Zealander Mikayla Harvey (Équipe Paule Ka) dropped out of the front group with a mechanical, but a dedicated chasing effort from her team brought her and the second group back to the front just before the second-category climb to Volturino started halfway through the stage.
On that ascent, nine riders broke attacked from the front group. Australian Lucy Kennedy (Mitchelton-Scott), Katia Ragusa (Astana Women’s Team), Amy Pieters (Boels Dolmans), Pauliena Rooijakkers (CCC-Liv), Jelena Eric (Movistar), Coryn Rivera (Team Sunweb), Ruth Winder (Trek-Segafredo), and Lisa Brennauer (Ceratizit-WNT) jumped away and built out a maximum lead of 40 seconds.
Maria Novolodskaia (Cogeas Mettler Look) bridged over to join the front group, but unfortunately crashed out of the lead on the descent, mirroring her crash while in the lead of the race on Stage 6.
The break was caught as the peloton entered the early slopes of the final climb of the stage.
After the first kilometre of climbing, the pace was on and the front group had been whittled down to just nine riders. Lizzie Deignan (Trek-Segafredo) set the pace for Longo Borghini, and they were followed by Niewiadoma, Cecilie Uttrup Ludwig (FDJ Nouvelle-Aquitaine), Harvey, Van der Breggen, Liane Lippert (Team Sunweb), Ashleigh Moolman-Pasio (CCC-Liv), and Niamh Fisher-Black (Équipe Paule Ka) were the only ones left in the fight for the maglia rosa now worn by Niewiadoma.
Moolman-Pasio and Fisher-Black were the first who had to let go due to Deignan’s pace. Lippert was the next to be dropped, but managed to close the gap again. Halfway up the climb, Van der Breggen attacked. Longo Borghini and Harvey jumped on her wheel, but after 300 metres, Harvey could not keep up anymore.
When the climb flattened out, Longo Borghini and Van der Breggen were 20 seconds ahead of Harvey and 48 seconds ahead of Niewiadoma and Uttrup Ludwig who had been joined by Katrine Aalerud (Movistar Team) and Rooijakkers.
After unsuccessfully trying to shake of Van der Breggen on a steep section just before the final kilometre, Longo Borghini led all the way to the finish, outsprinting the Dutch champion to win the stage.
Harvey finished in third place 31 seconds later. Katrine Aalerud (Movistar Team) finished fourth, a minute and six seconds behind, with Cecilie Uttrup Ludwig (FDJ Nouvelle-Aquitaine), Niewiadoma and Rooijakkers a further 13 seconds down.
SBS broadcasts a highlights show of the Giro Rosa, daily from 4.30pm.
