Van der Breggen completes worlds double with road race gold
The reigning Olympic champion attacked 40km from the finish line, beating compatriot Annemiek van Vleuten and Italian Elisa Longo Borghini, in a photo-finish 1min 20sec behind the winner.
The 30-year-old Dutchwoman becomes the first woman to achieve the double in the same year since the French rider Jeannie Longo in 1995.
"It was a really hard race, we were fighting from the beginning. The climbs were really tough.
"In the fourth lap, I felt strong. We made the race hard and I just went for it.
"I felt good but it was really hard. The circuit had some flat parts but it was very hard. I never expected this. This season is pretty good for me so far."
It was the fourth title in as many years for the Netherlands, the flagship country for women's cycling.
She attacked on the steepest part of the second climb of the course, building up a lead of more than two minutes at the start of the fifth and final lap, controlling the situation to the line.
Van Vleuten, who was competing with a fractured left wrist which she hurt just nine days ago in the Giro d'Italia, narrowly edged Italian Longo Borghini, who again settled for bronze after 2012.
She has been going from strength to strength winning the European time-trial title, the Giro, capping her season with the world double.
Dutch cycling great Marianne Vos -- a former Olympic and multiple world champion -- finished off the podium in fourth, two minutes adrift of the winner.