The Trek-Segafredo rider suffered a stroke on the day she was due to travel to Australia for the World Championships.
Elisa Longo Borghini takes first red jersey of race.
Former Italian champion says she has to find ways to gain time on the "goats" if she is to climb up the GC.
"Chapeau to her for an amazing sprint finish," says Grace Brown after ceding overall lead to Trek-Segafredo rider.
The Paris-Roubaix champion sprinted to third place, gapping Grace Brown and clinching bonus seconds to take overall victory.
Longo Borghini may have rode into the velodrome alone, but she says her team support was the reason she was there at all.
Sometimes hitting the smaller races can throw up some tech treats, and that's precisely what we got at Itzulia Basque Country.
World Champion Elisa Balsamo has been unbeatable in recent races, can she continue her winning streak?
With teams like Trek-Segafredo and Uno-X supporting maternity leave in sport, the culture around giving birth mid-career is changing.
"I’m a professional athlete in a professional cycling team, but the support feels very personal and I’m incredibly grateful.”