Cook the pasta in a large pot of salted water according to package directions. Reserve ½ cup of the pasta water before draining.
Brown the sausage in a large pan over medium heat, breaking it up with a spoon until fully cooked and crispy, about 8-10 minutes. Remove from the pan and set aside.
While the sausage is cooking in a separate pan over medium heat, add in butter and Panko bread crumbs. Cook, stirring occasionally, until browned and toasted, about 5 minutes. Set aside for topping later.
In the same pan as the sausage, sauté the shallots and garlic for 2 minutes until fragrant. Add the mushrooms, salt, and pepper and cook until softened and slightly golden, about 6-8 minutes. Toss in the chopped kale and cook until wilted, about 2 minutes.
Add the sausage to the pan, then pour in the heavy cream and parmesan cheese. Stir until the cheese is melted and the sauce is smooth.
Add the cooked orecchiette and a 1/4 cup of reserved pasta water. Stir and simmer for a few minutes until everything is coated and the sauce clings to the pasta. You can add more pasta water to get the sauce to your desired consistency and thin out the sauce. Serve warm with toasted bread crumbs and enjoy!