Brown the sausage in a large skillet over medium-high heat until just cooked through. Stir in 1 tbsp of tomato paste and cook for another 1-2 minutes, until caramelized. Transfer the sausage to a plate and set aside.

Return the pan to medium heat and add the olive oil. When shimmering, add the onions and peppers. Cook for 15-20 minutes, stirring often, until softened.

Add the remaining 1 tbsp tomato paste, garlic, brown sugar, oregano and balsamic vinegar. Season with kosher salt. Cook for another few minutes, until jammy and caramelized. If the peppers are taking too long to soften look dry at any point, add a splash of water to the pan and simmer over high heat until you reach the right consistency.

Meanwhile, cook the pasta in generously salted water for 1 minute less than the time indicated on the package. Reserve a 1/2 cup of the cooking liquid and drain.

Add the pasta and cooked sausage to the skillet with the peppers along with 1/4 cup pasta water. Cook for 2-3 minutes more, adding pasta cooking liquid if needed, until the pasta is al dente and the sauce is thickened. Serve immediately with toasted breadcrumbs if desired.